How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,445 to $11,749Professionalmedian $1,230 · 10th to 90th $977 to $2,089
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
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 $1,047.13 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,862.09 Typical High $2,454.71 | Professional | 50 · Both sides | $1,584.89 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $229.09 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,258.93 Median $1,258.93 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,258.93 | $2,818.38 |
Emblem Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $4,466.84 | Facility | None | $1,288.25 | $1,778.28 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,348.96 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,659.59 | Professional | None | $724.44 | $1,096.48 | $1,659.59 |
MVP Health Care Setting Facility Modifier None Typical Low $1,258.93 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,258.93 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,380.38 | $2,691.53 |
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 $812.83 Median $1,288.25 Typical High $3,090.30 | Professional | None | $812.83 | $1,288.25 | $3,090.30 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $5,011.87 | Facility | None | $851.14 | $1,174.90 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,659.59 | Professional | None | $851.14 | $1,096.48 | $1,659.59 |
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 $588.84 Median $588.84 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $851.14 Typical High $1,318.26 | Professional | 54 · Surgery only | $575.44 | $851.14 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | 55 · Aftercare only | $151.36 | $229.09 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $109.65 Typical High $165.96 | Professional | 56 · Pre-op care only | $72.44 | $109.65 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $741.31 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $501.19 | $741.31 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $676.08 Typical High $1,000.00 | Professional | 53 · Discontinued | $660.69 | $676.08 | $1,000.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $851.14 Typical High $1,318.26 | Professional | 54 · Surgery only | $575.44 | $851.14 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $229.09 Typical High $691.83 | Professional | 55 · Aftercare only | $151.36 | $229.09 | $691.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $109.65 Typical High $331.13 | Professional | 56 · Pre-op care only | $72.44 | $109.65 | $331.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $741.31 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $501.19 | $741.31 | $1,174.90 |
Where New York sits
The same service costs 17.8 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
$1,230
AK $5,129TX $288
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.