How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,175 to $12,303Professionalmedian $3,802 · 10th to 90th $3,090 to $5,012
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,715.35 | $4,265.80 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,388.44 | $3,981.07 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,137.96 Median $2,511.89 Typical High $3,311.31 | Professional | 62 · Two surgeons | $2,137.96 | $2,511.89 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $645.65 Typical High $831.76 | Professional | 80 · Assistant surgeon | $549.54 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $562.34 Typical High $724.44 | Professional | AS · PA/NP assist | $478.63 | $562.34 | $724.44 |
CDPHP Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Emblem Health Setting Facility Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $13,182.57 | Facility | None | $3,467.37 | $4,073.80 | $13,182.57 |
Emblem Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $7,079.46 | Professional | None | $3,981.07 | $3,981.07 | $7,079.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $4,786.30 | Professional | None | $1,905.46 | $3,162.28 | $4,786.30 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $5,011.87 | Professional | None | $3,548.13 | $3,548.13 | $5,011.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $5,370.32 | Professional | None | $2,511.89 | $3,388.44 | $5,370.32 |
Univera Setting Facility Modifier None Typical Low $2,238.72 Median $4,570.88 Typical High $12,022.64 | Facility | None | $2,238.72 | $4,570.88 | $12,022.64 |
Univera Setting Professional Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $4,786.30 | Professional | None | $1,905.46 | $3,162.28 | $4,786.30 |
14 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 $1,862.09 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,862.09 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $741.31 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,754.23 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $371.54 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,951.21 | $2,951.21 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,737.80 | $2,818.38 | $4,265.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $316.23 Typical High $478.63 | Professional | 55 · Aftercare only | $190.55 | $316.23 | $478.63 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $281.84 Typical High $426.58 | Professional | 56 · Pre-op care only | $173.78 | $281.84 | $426.58 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $3,890.45 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,737.80 | $2,818.38 | $4,265.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $316.23 Typical High $478.63 | Professional | 55 · Aftercare only | $190.55 | $316.23 | $478.63 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $281.84 Typical High $426.58 | Professional | 56 · Pre-op care only | $173.78 | $281.84 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $3,890.45 |
Where New York sits
The same service costs 27.5 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· 35th of 51
$3,802
AK $14,454TX $525
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.