How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,479 to $12,589Professionalmedian $1,585 · 10th to 90th $1,259 to $2,630
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 $2,238.72 Median $6,456.54 Typical High $13,182.57 | Facility | None | $2,238.72 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,584.89 | $1,659.59 |
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 $1,348.96 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,398.83 Typical High $3,090.30 | Professional | 50 · Both sides | $2,041.74 | $2,398.83 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,318.26 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $331.13 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $288.40 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $288.40 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $8,317.64 Typical High $16,595.87 | Facility | None | $2,041.74 | $8,317.64 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,630.78 | Professional | None | $1,548.82 | $1,548.82 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $5,754.40 | Facility | None | $1,348.96 | $1,819.70 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,737.80 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,089.30 | Professional | None | $891.25 | $1,380.38 | $2,089.30 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,621.81 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $3,548.13 | Professional | None | $1,698.24 | $1,778.28 | $3,548.13 |
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 $1,047.13 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,047.13 | $1,659.59 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $6,165.95 | Facility | None | $1,071.52 | $1,479.11 | $6,165.95 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,380.38 | $2,089.30 |
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 $794.33 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 53 · Discontinued | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,096.48 Typical High $1,778.28 | Professional | 54 · Surgery only | $707.95 | $1,096.48 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $295.12 Typical High $467.74 | Professional | 55 · Aftercare only | $190.55 | $295.12 | $467.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $138.04 Typical High $223.87 | Professional | 56 · Pre-op care only | $89.13 | $138.04 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $954.99 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $616.60 | $954.99 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $870.96 Typical High $1,258.93 | Professional | 53 · Discontinued | $851.14 | $870.96 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,096.48 Typical High $1,659.59 | Professional | 54 · Surgery only | $707.95 | $1,096.48 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $295.12 Typical High $851.14 | Professional | 55 · Aftercare only | $190.55 | $295.12 | $851.14 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $138.04 Typical High $398.11 | Professional | 56 · Pre-op care only | $89.13 | $138.04 | $398.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $954.99 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $616.60 | $954.99 | $1,479.11 |
Where New York sits
The same service costs 20.0 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
$1,585
AK $6,457TX $324
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.