How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $14,454Professionalmedian $1,660 · 10th to 90th $1,349 to $3,715
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 $1,905.46 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,905.46 | $1,995.26 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $15,488.17 | Facility | None | $1,862.09 | $8,709.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,621.81 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $2,137.96 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $537.03 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $229.09 Typical High $467.74 | Professional | AS · PA/NP assist | $194.98 | $229.09 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,884.03 | Facility | None | $851.14 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $9,120.11 | Professional | None | $1,621.81 | $1,995.26 | $9,120.11 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,819.70 | $3,090.30 | $6,760.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,238.72 | $3,630.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,548.82 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $5,754.40 Typical High $87,096.36 | Facility | None | $1,698.24 | $5,754.40 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,137.96 | $4,466.84 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,165.95 | Facility | None | $575.44 | $1,737.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $5,370.32 | Professional | None | $1,479.11 | $2,238.72 | $5,370.32 |
Univera Setting Facility Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $6,456.54 | Facility | None | $1,513.56 | $1,621.81 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,548.82 | $2,137.96 |
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 $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $954.99 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,412.54 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,412.54 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $199.53 Typical High $295.12 | Professional | 55 · Aftercare only | $165.96 | $199.53 | $295.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $169.82 Typical High $251.19 | Professional | 56 · Pre-op care only | $141.25 | $169.82 | $251.19 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,737.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,148.15 Typical High $1,698.24 | Professional | 53 · Discontinued | $831.76 | $1,148.15 | $1,698.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,862.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $199.53 Typical High $426.58 | Professional | 55 · Aftercare only | $165.96 | $199.53 | $426.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $169.82 Typical High $363.08 | Professional | 56 · Pre-op care only | $141.25 | $169.82 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,621.81 |
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· 41st of 51
$1,738
AK $6,918TX $1,175
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.