How much rates vary
Facilitymedian $4,571 · 10th to 90th $977 to $11,220Professionalmedian $813 · 10th to 90th $631 to $1,820
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 $724.44 Median $1,047.13 Typical High $1,819.70 | Professional | None | $724.44 | $1,047.13 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,548.82 | Professional | None | $645.65 | $758.58 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $977.24 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $245.47 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $218.78 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $218.78 |
CDPHP Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $794.33 Median $954.99 Typical High $3,090.30 | Professional | None | $794.33 | $954.99 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $3,090.30 | Facility | None | $812.83 | $1,513.56 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,513.56 | Professional | None | $794.33 | $912.01 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,230.27 | Professional | None | $562.34 | $724.44 | $1,230.27 |
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 $1,174.90 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,819.70 | $2,089.30 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $2,187.76 | Professional | None | $616.60 | $1,047.13 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $2,884.03 | Facility | None | $602.56 | $758.58 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,096.48 | Professional | None | $562.34 | $724.44 | $1,096.48 |
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 $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $741.31 | $741.31 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $602.56 Typical High $1,071.52 | Professional | 54 · Surgery only | $478.63 | $602.56 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $102.33 Typical High $173.78 | Professional | 55 · Aftercare only | $79.43 | $102.33 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $147.91 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $147.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $537.03 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $416.87 | $537.03 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $562.34 Typical High $851.14 | Professional | 53 · Discontinued | $426.58 | $562.34 | $851.14 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $630.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $478.63 | $630.96 | $1,023.29 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $102.33 Typical High $229.09 | Professional | 55 · Aftercare only | $79.43 | $102.33 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $194.98 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $537.03 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $416.87 | $537.03 | $870.96 |
Where New York sits
The same service costs 6.3 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
$832
AK $3,388UT $537
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.