How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,454Professionalmedian $2,455 · 10th to 90th $1,995 to $5,370
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 $2,454.71 Median $2,454.71 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,454.71 | $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 $2,089.30 Median $2,454.71 Typical High $4,897.79 | Professional | None | $2,089.30 | $2,454.71 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $776.25 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $676.08 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $676.08 |
CDPHP Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,265.80 | Facility | None | $851.14 | $1,778.28 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $12,589.25 | Professional | None | $2,398.83 | $2,818.38 | $12,589.25 |
Emblem Health Setting Facility Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $10,000.00 | Facility | None | $2,691.53 | $4,265.80 | $10,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,951.21 | $3,235.94 | $5,370.32 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,238.72 | $3,467.37 |
MVP Health Care Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,137.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $6,760.83 | Professional | None | $2,818.38 | $2,818.38 | $6,760.83 |
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 $2,137.96 Median $3,311.31 Typical High $8,128.31 | Professional | None | $2,137.96 | $3,311.31 | $8,128.31 |
Univera Setting Facility Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $11,748.98 | Facility | None | $2,238.72 | $2,454.71 | $11,748.98 |
Univera Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,238.72 | $3,235.94 |
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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | 53 · Discontinued | $489.78 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,949.84 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,659.59 | $1,949.84 | $3,235.94 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $295.12 Typical High $478.63 | Professional | 55 · Aftercare only | $251.19 | $295.12 | $478.63 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $251.19 Typical High $407.38 | Professional | 56 · Pre-op care only | $208.93 | $251.19 | $407.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,737.80 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,737.80 | $2,818.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,258.93 Median $1,737.80 Typical High $2,511.89 | Professional | 53 · Discontinued | $1,258.93 | $1,737.80 | $2,511.89 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,949.84 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,659.59 | $1,949.84 | $2,818.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $295.12 Typical High $630.96 | Professional | 55 · Aftercare only | $251.19 | $295.12 | $630.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $251.19 Typical High $537.03 | Professional | 56 · Pre-op care only | $208.93 | $251.19 | $537.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,737.80 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,737.80 | $2,454.71 |
Where New York sits
The same service costs 17.4 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
$2,512
AK $10,471TX $603
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.