How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,096 to $13,804Professionalmedian $977 · 10th to 90th $794 to $2,455
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 $1,071.52 Median $1,071.52 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,071.52 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $7,585.78 Typical High $14,791.08 | Facility | None | $1,737.80 | $7,585.78 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $2,238.72 | Professional | None | $794.33 | $933.25 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $3,388.44 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $588.84 Typical High $1,412.54 | Professional | 62 · Two surgeons | $501.19 | $588.84 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $354.81 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $316.23 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $4,677.35 | Professional | None | $1,047.13 | $1,513.56 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $4,677.35 | Facility | None | $1,288.25 | $1,548.82 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,513.56 | $2,454.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,548.82 | Professional | None | $812.83 | $1,096.48 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,122.02 Median $5,754.40 Typical High $23,442.29 | Facility | None | $1,122.02 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,380.38 | $2,951.21 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,258.93 Typical High $3,548.13 | Professional | None | $758.58 | $1,258.93 | $3,548.13 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $3,090.30 | Facility | None | $891.25 | $1,148.15 | $3,090.30 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,548.82 | Professional | None | $812.83 | $1,096.48 | $1,548.82 |
10 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 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $891.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $660.69 | $891.25 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $208.93 Typical High $302.00 | Professional | 55 · Aftercare only | $154.88 | $208.93 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $109.65 Typical High $158.49 | Professional | 56 · Pre-op care only | $81.28 | $109.65 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $1,148.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $891.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $660.69 | $891.25 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $208.93 Typical High $446.68 | Professional | 55 · Aftercare only | $154.88 | $208.93 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $109.65 Typical High $239.88 | Professional | 56 · Pre-op care only | $81.28 | $109.65 | $239.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $1,148.15 |
Where New York sits
The same service costs 6.8 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
$1,047
AK $5,012TX $741
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.