How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $14,454Professionalmedian $1,820 · 10th to 90th $1,445 to $3,311
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 $2,041.74 Median $2,041.74 Typical High $2,089.30 | Professional | None | $2,041.74 | $2,041.74 | $2,089.30 |
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 $1,513.56 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,778.28 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,122.02 Typical High $1,621.81 | Professional | 62 · Two surgeons | $954.99 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $407.38 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $251.19 Typical High $354.81 | Professional | AS · PA/NP assist | $213.80 | $251.19 | $354.81 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,778.28 | $1,819.70 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $7,413.10 | Facility | None | $1,995.26 | $2,398.83 | $7,413.10 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,778.28 | $2,238.72 | $3,467.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,698.24 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $1,819.70 Median $5,754.40 Typical High $48,977.88 | Facility | None | $1,819.70 | $5,754.40 | $48,977.88 |
MVP Health Care Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $4,897.79 | Professional | None | $1,905.46 | $2,290.87 | $4,897.79 |
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 $1,202.26 Median $2,238.72 Typical High $5,248.07 | Professional | None | $1,202.26 | $2,238.72 | $5,248.07 |
Univera Setting Facility Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $6,456.54 | Facility | None | $1,659.59 | $1,778.28 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,698.24 | $2,344.23 |
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 $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 53 · Discontinued | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $223.87 Typical High $302.00 | Professional | 55 · Aftercare only | $181.97 | $223.87 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $186.21 Typical High $257.04 | Professional | 56 · Pre-op care only | $154.88 | $186.21 | $257.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,778.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $1,412.54 | Professional | 53 · Discontinued | $954.99 | $954.99 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $2,041.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $223.87 Typical High $602.56 | Professional | 55 · Aftercare only | $181.97 | $223.87 | $602.56 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $186.21 Typical High $512.86 | Professional | 56 · Pre-op care only | $154.88 | $186.21 | $512.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,778.28 |
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· 44th of 51
$1,820
AK $7,586TX $331
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.