How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,413 to $11,749Professionalmedian $1,202 · 10th to 90th $955 to $2,042
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 $1,513.56 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,513.56 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
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 $1,584.89 | Professional | None | $1,023.29 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,819.70 Typical High $2,398.83 | Professional | 50 · Both sides | $1,548.82 | $1,819.70 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,000.00 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $223.87 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $223.87 |
CDPHP Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $12,882.50 | Facility | None | $4,365.16 | $4,365.16 | $12,882.50 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,737.80 | $6,309.57 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,202.26 | $2,818.38 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $4,365.16 | Facility | None | $1,230.27 | $1,621.81 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,318.26 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,621.81 | Professional | None | $707.95 | $1,071.52 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,659.59 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,951.21 | Professional | None | $794.33 | $1,258.93 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $831.76 Median $1,122.02 Typical High $5,011.87 | Facility | None | $831.76 | $1,122.02 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None | $831.76 | $1,071.52 | $1,621.81 |
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 $602.56 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $912.01 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $1,380.38 | Professional | 54 · Surgery only | $549.54 | $831.76 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $363.08 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $363.08 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $107.15 Typical High $173.78 | Professional | 56 · Pre-op care only | $70.79 | $107.15 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $724.44 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $724.44 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $660.69 Typical High $954.99 | Professional | 53 · Discontinued | $645.65 | $660.69 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $1,288.25 | Professional | 54 · Surgery only | $549.54 | $831.76 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $660.69 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $660.69 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $107.15 Typical High $316.23 | Professional | 56 · Pre-op care only | $70.79 | $107.15 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $489.78 | $724.44 | $1,122.02 |
Where New York sits
The same service costs 16.2 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· 44th of 51
$1,202
AK $5,012TX $309
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.