How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,318 to $14,125Professionalmedian $776 · 10th to 90th $631 to $1,318
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 $1,862.09 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,862.09 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | None | $812.83 | $812.83 | $891.25 |
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 $645.65 Median $758.58 Typical High $1,071.52 | Professional | None | $645.65 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,148.15 Typical High $1,584.89 | Professional | 50 · Both sides | $977.24 | $1,148.15 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $660.69 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $169.82 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $147.91 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $147.91 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,445.44 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,778.28 | Professional | None | $794.33 | $794.33 | $1,778.28 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $3,090.30 | Facility | None | $870.96 | $1,148.15 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,380.38 | Professional | None | $741.31 | $891.25 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,047.13 | Professional | None | $457.09 | $707.95 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $812.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,041.74 | Professional | None | $831.76 | $1,148.15 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,949.84 | Professional | None | $537.03 | $812.83 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $3,311.31 | Facility | None | $537.03 | $741.31 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,047.13 | Professional | None | $537.03 | $707.95 | $1,047.13 |
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 $407.38 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $562.34 Typical High $891.25 | Professional | 54 · Surgery only | $363.08 | $562.34 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $147.91 Typical High $239.88 | Professional | 55 · Aftercare only | $95.50 | $147.91 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $70.79 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $70.79 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $489.78 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $316.23 | $489.78 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $616.60 | Professional | 53 · Discontinued | $416.87 | $426.58 | $616.60 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $562.34 Typical High $831.76 | Professional | 54 · Surgery only | $363.08 | $562.34 | $831.76 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $147.91 Typical High $426.58 | Professional | 55 · Aftercare only | $95.50 | $147.91 | $426.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $70.79 Typical High $204.17 | Professional | 56 · Pre-op care only | $45.71 | $70.79 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $489.78 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $316.23 | $489.78 | $741.31 |
Where New York sits
The same service costs 7.4 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· 46th of 51
$794
AK $3,311TX $447
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.