How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,148 to $10,233Professionalmedian $2,188 · 10th to 90th $1,549 to $3,388
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,398.83 | $2,691.53 | $2,691.53 |
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 $1,905.46 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,905.46 | $2,238.72 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,412.54 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,174.90 | $1,412.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $537.03 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $478.63 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $478.63 |
CDPHP Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,801.89 | Facility | None | $851.14 | $1,778.28 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $4,365.16 | Professional | None | $1,995.26 | $1,995.26 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,630.27 Typical High $8,317.64 | Facility | None | $1,348.96 | $2,630.27 | $8,317.64 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,466.84 | Professional | None | $2,187.76 | $2,511.89 | $4,466.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,995.26 | $3,090.30 |
MVP Health Care Setting Facility Modifier None Typical Low $2,238.72 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,238.72 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,715.35 | Professional | None | $1,318.26 | $1,318.26 | $3,715.35 |
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 $1,584.89 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,187.76 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $1,445.44 | $2,187.76 | $6,760.83 |
Univera Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,995.26 | $3,090.30 |
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 $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,202.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $478.63 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $1,905.46 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,819.70 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,122.02 | $1,819.70 | $2,754.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $199.53 Typical High $309.03 | Professional | 55 · Aftercare only | $123.03 | $199.53 | $309.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $181.97 Typical High $275.42 | Professional | 56 · Pre-op care only | $112.20 | $181.97 | $275.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,621.81 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,621.81 | $2,454.71 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,621.81 Typical High $2,187.76 | Professional | 53 · Discontinued | $1,202.26 | $1,621.81 | $2,187.76 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,819.70 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,122.02 | $1,819.70 | $2,754.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $199.53 Typical High $446.68 | Professional | 55 · Aftercare only | $123.03 | $199.53 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $181.97 Typical High $398.11 | Professional | 56 · Pre-op care only | $112.20 | $181.97 | $398.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,621.81 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,621.81 | $2,454.71 |
Where New York sits
The same service costs 22.4 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· 42nd of 51
$2,188
AK $7,943TX $355
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.