How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,230 to $14,454Professionalmedian $2,188 · 10th to 90th $1,514 to $2,884
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 $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,778.28 | $2,041.74 | $2,041.74 |
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 $2,041.74 Median $2,398.83 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,398.83 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,513.56 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,288.25 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $389.05 Typical High $426.58 | Professional | 80 · Assistant surgeon | $331.13 | $389.05 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $338.84 Typical High $371.54 | Professional | AS · PA/NP assist | $288.40 | $338.84 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $6,025.60 | Facility | None | $1,288.25 | $2,754.23 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,584.89 | $3,890.45 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,737.80 | $3,235.94 | $6,606.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,905.46 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,445.44 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,513.56 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,659.59 | $2,041.74 | $4,265.80 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,606.93 | Facility | None | $575.44 | $1,778.28 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,047.13 | $1,949.84 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,548.82 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,445.44 | $2,041.74 |
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 $891.25 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $891.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $177.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,412.54 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $263.03 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $263.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,096.48 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $912.01 | $1,096.48 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $1,202.26 | Professional | 53 · Discontinued | $831.76 | $831.76 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,778.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $512.86 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $436.52 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $436.52 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,096.48 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $912.01 | $1,096.48 | $1,548.82 |
Where New York sits
The same service costs 22.9 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· 19th of 51
$2,188
AK $6,607TX $288
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.