How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,122 to $11,482Professionalmedian $1,698 · 10th to 90th $1,349 to $3,467
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,754.23 | Professional | None | $2,089.30 | $2,089.30 | $2,754.23 |
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 $1,445.44 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,698.24 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,949.84 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $501.19 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $436.52 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $436.52 |
CDPHP Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,513.56 Median $1,905.46 Typical High $6,918.31 | Professional | None | $1,513.56 | $1,905.46 | $6,918.31 |
Emblem Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $6,025.60 | Facility | None | $1,659.59 | $2,238.72 | $6,025.60 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,949.84 | $3,162.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,513.56 | $2,511.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,905.46 Median $4,786.30 Typical High $23,442.29 | Facility | None | $1,905.46 | $4,786.30 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,365.16 | Professional | None | $2,511.89 | $2,511.89 | $4,365.16 |
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 $1,202.26 Median $1,819.70 Typical High $4,786.30 | Professional | None | $1,202.26 | $1,819.70 | $4,786.30 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $6,309.57 | Facility | None | $1,000.00 | $1,548.82 | $6,309.57 |
Univera Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,513.56 | $2,511.89 |
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 $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 53 · Discontinued | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,348.96 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,071.52 | $1,348.96 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $281.84 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $281.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $151.36 Typical High $281.84 | Professional | 56 · Pre-op care only | $117.49 | $151.36 | $281.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,202.26 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $954.99 | $1,202.26 | $2,238.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,174.90 Typical High $1,778.28 | Professional | 53 · Discontinued | $912.01 | $1,174.90 | $1,778.28 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,071.52 | $1,380.38 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $154.88 Typical High $346.74 | Professional | 55 · Aftercare only | $117.49 | $154.88 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $154.88 Typical High $346.74 | Professional | 56 · Pre-op care only | $117.49 | $154.88 | $346.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,230.27 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $954.99 | $1,230.27 | $2,041.74 |
Where New York sits
The same service costs 5.9 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· 45th of 51
$1,778
AK $7,079UT $1,202
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.