How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,318 to $11,482Professionalmedian $1,585 · 10th to 90th $537 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 $5,754.40 Typical High $11,748.98 | Facility | None | $1,819.70 | $5,754.40 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $1,513.56 Typical High $2,344.23 | Professional | None | $446.68 | $1,513.56 | $2,344.23 |
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 $1,348.96 Median $1,584.89 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,584.89 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $2,089.30 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $2,089.30 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $2,570.40 | Professional | None | $645.65 | $645.65 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,238.72 | $4,786.30 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $1,778.28 Typical High $4,786.30 | Professional | None | $478.63 | $1,778.28 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $1,659.59 | Facility | None | $436.52 | $575.44 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,737.80 | $1,995.26 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $1,513.56 Typical High $2,238.72 | Professional | None | $489.78 | $1,513.56 | $2,238.72 |
MVP Health Care Setting Facility Modifier None Typical Low $575.44 Median $3,235.94 Typical High $4,365.16 | Facility | None | $575.44 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,511.89 | $3,467.37 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,715.35 Typical High $11,481.54 | Facility | None | $1,318.26 | $3,715.35 | $11,481.54 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,318.26 Typical High $3,548.13 | Professional | None | $407.38 | $1,318.26 | $3,548.13 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $1,412.54 Typical High $5,011.87 | Facility | None | $331.13 | $1,412.54 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $1,513.56 Typical High $2,041.74 | Professional | None | $489.78 | $1,513.56 | $2,041.74 |
13 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 54 · Surgery only Typical Low $331.13 Median $1,122.02 Typical High $1,737.80 | Professional | 54 · Surgery only | $331.13 | $1,122.02 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $229.09 Typical High $346.74 | Professional | 55 · Aftercare only | $66.07 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $151.36 Typical High $234.42 | Professional | 56 · Pre-op care only | $44.67 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,047.13 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $309.03 | $1,047.13 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,288.25 Typical High $1,949.84 | Professional | 54 · Surgery only | $912.01 | $1,288.25 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $208.93 Typical High $316.23 | Professional | 55 · Aftercare only | $147.91 | $208.93 | $316.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $275.42 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $275.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,122.02 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $776.25 | $1,122.02 | $1,698.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,202.26 Typical High $1,659.59 | Professional | 53 · Discontinued | $912.01 | $1,202.26 | $1,659.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,288.25 Typical High $1,819.70 | Professional | 54 · Surgery only | $912.01 | $1,288.25 | $1,819.70 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $208.93 Typical High $426.58 | Professional | 55 · Aftercare only | $147.91 | $208.93 | $426.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $363.08 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,122.02 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $776.25 | $1,122.02 | $1,584.89 |
Where New York sits
The same service costs 4.5 times more in Alaska than in Nebraska. 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· 36th of 51
$1,585
AK $3,981NE $891
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.