How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,738 to $16,596Professionalmedian $3,162 · 10th to 90th $2,570 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 $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,162.28 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $4,786.30 Typical High $6,456.54 | Professional | 50 · Both sides | $4,073.80 | $4,786.30 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $1,995.26 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,698.24 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $512.86 Typical High $691.83 | Professional | 80 · Assistant surgeon | $436.52 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $446.68 Typical High $602.56 | Professional | AS · PA/NP assist | $380.19 | $446.68 | $602.56 |
CDPHP Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $22,387.21 Typical High $45,708.82 | Facility | None | $1,737.80 | $22,387.21 | $45,708.82 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $7,079.46 | Professional | None | $3,235.94 | $3,235.94 | $7,079.46 |
Emblem Health Setting Facility Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $11,220.18 | Facility | None | $3,235.94 | $4,073.80 | $11,220.18 |
Emblem Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,467.37 Typical High $5,495.41 | Professional | None | $3,019.95 | $3,467.37 | $5,495.41 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,819.70 | $2,754.23 | $4,265.80 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $5,754.40 | Facility | None | $3,235.94 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $7,585.78 | Professional | None | $3,388.44 | $5,370.32 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $7,413.10 | Professional | None | $2,089.30 | $3,388.44 | $7,413.10 |
Univera Setting Facility Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $15,488.17 | Facility | None | $2,137.96 | $3,019.95 | $15,488.17 |
Univera Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,754.23 | $4,265.80 |
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,511.89 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,398.83 | $2,398.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,187.76 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,445.44 | $2,187.76 | $3,548.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $575.44 Typical High $954.99 | Professional | 55 · Aftercare only | $389.05 | $575.44 | $954.99 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $275.42 Typical High $457.09 | Professional | 56 · Pre-op care only | $181.97 | $275.42 | $457.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,905.46 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,905.46 | $3,162.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,737.80 Typical High $2,570.40 | Professional | 53 · Discontinued | $1,698.24 | $1,737.80 | $2,570.40 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,187.76 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,445.44 | $2,187.76 | $3,311.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $575.44 Typical High $1,698.24 | Professional | 55 · Aftercare only | $389.05 | $575.44 | $1,698.24 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $275.42 Typical High $812.83 | Professional | 56 · Pre-op care only | $181.97 | $275.42 | $812.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,905.46 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,905.46 | $3,019.95 |
Where New York sits
The same service costs 20.4 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· 43rd of 51
$3,236
AK $13,183TX $646
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.