How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,349 to $11,749Professionalmedian $977 · 10th to 90th $776 to $1,660
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 $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,023.29 | $1,047.13 |
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 $831.76 Median $977.24 Typical High $1,318.26 | Professional | None | $831.76 | $977.24 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,445.44 Typical High $1,995.26 | Professional | 50 · Both sides | $1,230.27 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $831.76 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $213.80 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $186.21 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,584.89 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,187.76 | Professional | None | $977.24 | $977.24 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,348.96 Typical High $3,548.13 | Facility | None | $977.24 | $1,348.96 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,698.24 | Professional | None | $933.25 | $1,071.52 | $1,698.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,318.26 | Professional | None | $562.34 | $851.14 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $977.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,230.27 | $2,137.96 |
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 $645.65 Median $1,023.29 Typical High $2,398.83 | Professional | None | $645.65 | $1,023.29 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $4,466.84 | Facility | None | $676.08 | $933.25 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,318.26 | Professional | None | $676.08 | $851.14 | $1,318.26 |
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 $512.86 Median $512.86 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $741.31 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $676.08 Typical High $1,047.13 | Professional | 54 · Surgery only | $446.68 | $676.08 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $177.83 Typical High $275.42 | Professional | 55 · Aftercare only | $120.23 | $177.83 | $275.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $85.11 Typical High $131.83 | Professional | 56 · Pre-op care only | $56.23 | $85.11 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $588.84 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $389.05 | $588.84 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $537.03 Typical High $776.25 | Professional | 53 · Discontinued | $524.81 | $537.03 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $676.08 Typical High $1,047.13 | Professional | 54 · Surgery only | $446.68 | $676.08 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $177.83 Typical High $549.54 | Professional | 55 · Aftercare only | $120.23 | $177.83 | $549.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $85.11 Typical High $257.04 | Professional | 56 · Pre-op care only | $56.23 | $85.11 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $588.84 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $389.05 | $588.84 | $933.25 |
Where New York sits
The same service costs 18.2 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· 45th of 51
$977
AK $4,074TX $224
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.