How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,175 · 10th to 90th $933 to $2,455
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 $1,412.54 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,479.11 | $2,187.76 |
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 $1,000.00 Median $1,174.90 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,174.90 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $3,235.94 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,380.38 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $346.74 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $302.00 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,071.52 Median $1,318.26 Typical High $4,786.30 | Professional | None | $1,071.52 | $1,318.26 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,089.30 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,348.96 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,949.84 | Professional | None | $870.96 | $1,047.13 | $1,949.84 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $4,786.30 | Facility | None | $1,318.26 | $1,318.26 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,737.80 | $1,778.28 | $3,019.95 |
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 $891.25 Median $1,288.25 Typical High $3,388.44 | Professional | None | $891.25 | $1,288.25 | $3,388.44 |
Univera Setting Facility Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $4,897.79 | Facility | None | $1,023.29 | $1,096.48 | $4,897.79 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,778.28 | Professional | None | $870.96 | $1,047.13 | $1,778.28 |
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 $707.95 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $707.95 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $281.84 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $954.99 Typical High $1,819.70 | Professional | 54 · Surgery only | $776.25 | $954.99 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $177.83 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $158.49 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,659.59 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $812.83 Typical High $1,230.27 | Professional | 53 · Discontinued | $630.96 | $812.83 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $954.99 Typical High $1,778.28 | Professional | 54 · Surgery only | $776.25 | $954.99 | $1,778.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $213.80 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $213.80 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,621.81 |
Where New York sits
The same service costs 5.9 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
$1,230
AK $4,898TX $832
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.