How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,202 to $10,965Professionalmedian $550 · 10th to 90th $468 to $1,318
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 $724.44 Median $776.25 Typical High $1,698.24 | Professional | None | $724.44 | $776.25 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,174.90 | Professional | None | $457.09 | $537.03 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $346.74 Typical High $691.83 | Professional | 62 · Two surgeons | $295.12 | $346.74 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $89.13 Typical High $181.97 | Professional | 80 · Assistant surgeon | $75.86 | $89.13 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $158.49 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $158.49 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $8,912.51 | Facility | None | $1,318.26 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $2,454.71 | Professional | None | $549.54 | $676.08 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $2,238.72 | Facility | None | $346.74 | $676.08 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,174.90 | Professional | None | $616.60 | $707.95 | $1,174.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $954.99 | Professional | None | $446.68 | $549.54 | $954.99 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,786.30 | Facility | None | $691.83 | $691.83 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,548.82 | Professional | None | $724.44 | $724.44 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,737.80 | Professional | None | $467.74 | $660.69 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $562.34 Typical High $2,290.87 | Facility | None | $524.81 | $562.34 | $2,290.87 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $933.25 | Professional | None | $446.68 | $549.54 | $933.25 |
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 $363.08 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $537.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $912.01 | Professional | 54 · Surgery only | $407.38 | $501.19 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $91.20 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $91.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $44.67 Typical High $81.28 | Professional | 56 · Pre-op care only | $36.31 | $44.67 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $457.09 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $371.54 | $457.09 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $426.58 Typical High $645.65 | Professional | 53 · Discontinued | $323.59 | $426.58 | $645.65 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $912.01 | Professional | 54 · Surgery only | $407.38 | $501.19 | $912.01 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $112.20 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $112.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $44.67 Typical High $100.00 | Professional | 56 · Pre-op care only | $36.31 | $44.67 | $100.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $457.09 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $371.54 | $457.09 | $831.76 |
Where New York sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 49th of 51
$589
AK $2,570UT $479
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.