How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,479 to $11,749Professionalmedian $1,259 · 10th to 90th $1,023 to $2,399
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 $5,754.40 Typical High $11,481.54 | Facility | None | $1,819.70 | $5,754.40 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,202.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $288.40 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $257.04 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $257.04 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $13,489.63 | Facility | None | $1,778.28 | $6,760.83 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,230.27 | $3,235.94 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $4,786.30 | Facility | None | $1,445.44 | $1,949.84 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,479.11 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,174.90 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,412.54 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,412.54 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,445.44 | $1,819.70 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $13,182.57 | Facility | None | $1,318.26 | $3,548.13 | $13,182.57 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,584.89 Typical High $3,801.89 | Professional | None | $812.83 | $1,584.89 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $4,897.79 | Facility | None | $1,230.27 | $1,258.93 | $4,897.79 |
Univera Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,174.90 | $1,584.89 |
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 $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,513.56 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $229.09 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $128.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $109.65 | $128.82 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $891.25 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $758.58 | $891.25 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $758.58 Typical High $1,174.90 | Professional | 53 · Discontinued | $724.44 | $758.58 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,380.38 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $457.09 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $457.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $128.82 Typical High $389.05 | Professional | 56 · Pre-op care only | $109.65 | $128.82 | $389.05 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $758.58 | $891.25 | $1,258.93 |
Where New York sits
The same service costs 7.2 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· 46th of 51
$1,259
AK $5,495TX $759
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.