How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $10,000Professionalmedian $1,122 · 10th to 90th $912 to $1,738
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 $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,380.38 | $1,380.38 |
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 $954.99 Median $1,122.02 Typical High $1,737.80 | Professional | None | $954.99 | $1,122.02 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $1,096.48 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $275.42 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $245.47 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $245.47 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,000.00 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $4,365.16 | Facility | None | $1,023.29 | $1,348.96 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,318.26 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,584.89 | Professional | None | $794.33 | $1,047.13 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,122.02 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,122.02 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,148.15 | $1,905.46 |
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 $812.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $812.83 | $1,122.02 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,122.02 Typical High $3,981.07 | Facility | None | $741.31 | $1,122.02 | $3,981.07 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,584.89 | Professional | None | $794.33 | $1,047.13 | $1,584.89 |
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 $616.60 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $933.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $575.44 | $933.25 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $104.71 Typical High $158.49 | Professional | 55 · Aftercare only | $63.10 | $104.71 | $158.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $93.33 Typical High $141.25 | Professional | 56 · Pre-op care only | $57.54 | $93.33 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $851.14 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $512.86 | $851.14 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $812.83 Typical High $1,122.02 | Professional | 53 · Discontinued | $616.60 | $812.83 | $1,122.02 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $933.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $575.44 | $933.25 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $104.71 Typical High $229.09 | Professional | 55 · Aftercare only | $63.10 | $104.71 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $93.33 Typical High $204.17 | Professional | 56 · Pre-op care only | $57.54 | $93.33 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $851.14 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $512.86 | $851.14 | $1,288.25 |
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· 45th of 51
$1,122
AK $4,266TX $794
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.