How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $9,772Professionalmedian $741 · 10th to 90th $589 to $1,549
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,819.70 | Professional | None | $870.96 | $1,096.48 | $1,819.70 |
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 $616.60 Median $724.44 Typical High $1,348.96 | Professional | None | $616.60 | $724.44 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $870.96 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $190.55 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $190.55 |
CDPHP Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $660.69 Median $870.96 Typical High $3,019.95 | Professional | None | $660.69 | $870.96 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,884.03 | Facility | None | $812.83 | $1,258.93 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,380.38 | Professional | None | $741.31 | $851.14 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,202.26 | Professional | None | $537.03 | $660.69 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $4,786.30 | Facility | None | $851.14 | $851.14 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,023.29 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,344.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $2,089.30 | Professional | None | $562.34 | $794.33 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $630.96 Median $676.08 Typical High $2,818.38 | Facility | None | $630.96 | $676.08 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,122.02 | Professional | None | $537.03 | $660.69 | $1,122.02 |
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 $436.52 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $776.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $1,148.15 | Professional | 54 · Surgery only | $489.78 | $602.56 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $112.20 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $100.00 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $100.00 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $512.86 Typical High $794.33 | Professional | 53 · Discontinued | $389.05 | $512.86 | $794.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $1,096.48 | Professional | 54 · Surgery only | $489.78 | $602.56 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $134.90 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $134.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $120.23 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $120.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $1,000.00 |
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· 47th of 51
$776
AK $3,090TX $525
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.