How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $11,220Professionalmedian $2,042 · 10th to 90th $1,622 to $4,169
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 $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,570.40 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,041.74 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,288.25 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,096.48 | $1,288.25 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $602.56 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $524.81 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $524.81 |
CDPHP Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,311.31 | Facility | None | $851.14 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $8,128.31 | Professional | None | $1,819.70 | $2,238.72 | $8,128.31 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $7,079.46 | Facility | None | $1,348.96 | $2,187.76 | $7,079.46 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,344.23 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,778.28 | $3,090.30 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $4,786.30 | Facility | None | $2,290.87 | $2,290.87 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $5,248.07 | Professional | None | $2,818.38 | $2,818.38 | $5,248.07 |
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 $1,513.56 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,513.56 | $2,238.72 | $5,754.40 |
Univera Setting Facility Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $7,762.47 | Facility | None | $1,737.80 | $1,862.09 | $7,762.47 |
Univera Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,778.28 | $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 $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,202.26 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,819.70 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,621.81 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,348.96 | $1,621.81 | $3,019.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $302.00 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $144.54 Typical High $263.03 | Professional | 56 · Pre-op care only | $117.49 | $144.54 | $263.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $2,754.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,412.54 Typical High $2,137.96 | Professional | 53 · Discontinued | $1,096.48 | $1,412.54 | $2,137.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,621.81 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,348.96 | $1,621.81 | $3,019.95 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $371.54 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $144.54 Typical High $331.13 | Professional | 56 · Pre-op care only | $117.49 | $144.54 | $331.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $2,754.23 |
Where New York sits
The same service costs 6.2 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
$2,138
AK $8,511TX $1,380
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.