How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,122 to $10,000Professionalmedian $1,349 · 10th to 90th $1,072 to $2,818
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 $1,548.82 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,548.82 | $2,238.72 |
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 $1,148.15 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $1,659.59 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $416.87 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $363.08 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $363.08 |
CDPHP Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,348.96 Median $1,548.82 Typical High $5,623.41 | Professional | None | $1,348.96 | $1,548.82 | $5,623.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $5,248.07 | Facility | None | $1,445.44 | $2,238.72 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,698.24 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,187.76 | Professional | None | $977.24 | $1,258.93 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,786.30 | Facility | None | $1,348.96 | $1,348.96 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,778.28 | $1,778.28 | $3,467.37 |
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 $1,096.48 Median $1,513.56 Typical High $4,168.69 | Professional | None | $1,096.48 | $1,513.56 | $4,168.69 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $4,786.30 | Facility | None | $1,148.15 | $1,318.26 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,187.76 | Professional | None | $977.24 | $1,258.93 | $2,187.76 |
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 $776.25 Median $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,148.15 Typical High $1,995.26 | Professional | 54 · Surgery only | $891.25 | $1,148.15 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $199.53 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $177.83 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $177.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $1,819.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $977.24 Typical High $1,412.54 | Professional | 53 · Discontinued | $707.95 | $977.24 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,148.15 Typical High $1,995.26 | Professional | 54 · Surgery only | $891.25 | $1,148.15 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $245.47 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $218.78 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $218.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $1,819.70 |
Where New York sits
The same service costs 21.4 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· 44th of 51
$1,413
AK $5,754TX $269
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.