How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,096 to $10,233Professionalmedian $1,660 · 10th to 90th $1,349 to $2,570
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,819.70 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,659.59 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $380.19 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $354.81 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $354.81 |
CDPHP Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,884.03 | Facility | None | $851.14 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,479.11 | $3,388.44 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $6,456.54 | Facility | None | $1,737.80 | $2,089.30 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,621.81 | $1,949.84 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,513.56 | $2,290.87 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $5,754.40 Typical High $41,686.94 | Facility | None | $1,698.24 | $5,754.40 | $41,686.94 |
MVP Health Care Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,041.74 | $2,818.38 |
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 $1,230.27 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,659.59 | $2,630.27 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $6,025.60 | Facility | None | $1,096.48 | $1,621.81 | $6,025.60 |
Univera Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,513.56 | $2,290.87 |
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 $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $363.08 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,412.54 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,380.38 Typical High $2,089.30 | Professional | 54 · Surgery only | $831.76 | $1,380.38 | $2,089.30 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $151.36 Typical High $229.09 | Professional | 55 · Aftercare only | $93.33 | $151.36 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $138.04 Typical High $208.93 | Professional | 56 · Pre-op care only | $83.18 | $138.04 | $208.93 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,230.27 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $758.58 | $1,230.27 | $1,862.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,202.26 Typical High $1,659.59 | Professional | 53 · Discontinued | $912.01 | $1,202.26 | $1,659.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,380.38 Typical High $2,089.30 | Professional | 54 · Surgery only | $831.76 | $1,380.38 | $2,089.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $151.36 Typical High $338.84 | Professional | 55 · Aftercare only | $93.33 | $151.36 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $138.04 Typical High $302.00 | Professional | 56 · Pre-op care only | $83.18 | $138.04 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,230.27 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $758.58 | $1,230.27 | $1,862.09 |
Where New York sits
The same service costs 5.4 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
$1,660
AK $6,026TX $1,122
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.