How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,454Professionalmedian $2,239 · 10th to 90th $1,820 to $4,898
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $5,248.07 | Professional | None | $2,511.89 | $2,884.03 | $5,248.07 |
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 $1,862.09 Median $2,187.76 Typical High $4,466.84 | Professional | None | $1,862.09 | $2,187.76 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,380.38 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,174.90 | $1,380.38 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $346.74 Typical High $691.83 | Professional | 80 · Assistant surgeon | $295.12 | $346.74 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $616.60 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,801.89 | Facility | None | $851.14 | $1,778.28 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $12,302.69 | Professional | None | $2,137.96 | $2,511.89 | $12,302.69 |
Emblem Health Setting Facility Modifier None Typical Low $2,630.27 Median $3,981.07 Typical High $8,709.64 | Facility | None | $2,630.27 | $3,981.07 | $8,709.64 |
Emblem Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $5,128.61 | Professional | None | $2,511.89 | $2,884.03 | $5,128.61 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,995.26 | $2,818.38 |
MVP Health Care Setting Facility Modifier None Typical Low $2,238.72 Median $5,754.40 Typical High $87,096.36 | Facility | None | $2,238.72 | $5,754.40 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $6,025.60 | Professional | None | $2,754.23 | $2,754.23 | $6,025.60 |
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 $1,905.46 Median $2,951.21 Typical High $7,244.36 | Professional | None | $1,905.46 | $2,951.21 | $7,244.36 |
Univera Setting Facility Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $6,165.95 | Facility | None | $1,995.26 | $2,137.96 | $6,165.95 |
Univera Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,995.26 | $2,818.38 |
14 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 $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,862.09 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,995.26 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,737.80 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,479.11 | $1,737.80 | $2,630.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $263.03 Typical High $389.05 | Professional | 55 · Aftercare only | $218.78 | $263.03 | $389.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | 56 · Pre-op care only | $186.21 | $218.78 | $331.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,513.56 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,513.56 | $2,290.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,737.80 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,479.11 | $1,737.80 | $2,454.71 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $263.03 Typical High $562.34 | Professional | 55 · Aftercare only | $218.78 | $263.03 | $562.34 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $218.78 Typical High $478.63 | Professional | 56 · Pre-op care only | $186.21 | $218.78 | $478.63 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,513.56 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,513.56 | $2,137.96 |
Where New York sits
The same service costs 14.5 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· 40th of 51
$2,291
AK $9,120TX $631
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.