How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,202 to $8,128Professionalmedian $955 · 10th to 90th $813 to $1,549
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,819.70 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,148.15 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,513.56 | Professional | None | $812.83 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $602.56 Typical High $954.99 | Professional | 62 · Two surgeons | $512.86 | $602.56 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $239.88 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $208.93 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $208.93 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $4,897.79 | Facility | None | $1,412.54 | $2,398.83 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $2,041.74 | Professional | None | $851.14 | $891.25 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $4,073.80 | Facility | None | $912.01 | $1,288.25 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,230.27 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,479.11 | Professional | None | $741.31 | $1,000.00 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,047.13 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,047.13 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,659.59 | Professional | None | $933.25 | $933.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | None | $741.31 | $1,000.00 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $3,235.94 | Facility | None | $707.95 | $1,000.00 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,479.11 | Professional | None | $741.31 | $1,000.00 | $1,479.11 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $912.01 Typical High $1,348.96 | Professional | 54 · Surgery only | $537.03 | $912.01 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $147.91 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $91.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $53.70 | $91.20 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $812.83 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $741.31 Typical High $1,096.48 | Professional | 53 · Discontinued | $575.44 | $741.31 | $1,096.48 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $912.01 Typical High $1,348.96 | Professional | 54 · Surgery only | $537.03 | $912.01 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $218.78 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $91.20 Typical High $194.98 | Professional | 56 · Pre-op care only | $53.70 | $91.20 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $812.83 | $1,202.26 |
Where New York sits
The same service costs 5.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 46th of 51
$955
AK $3,981TX $759
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.