How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,413 to $14,454Professionalmedian $933 · 10th to 90th $759 to $1,549
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 $6,309.57 Typical High $12,589.25 | Facility | None | $1,905.46 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $776.25 Median $912.01 Typical High $1,288.25 | Professional | None | $776.25 | $912.01 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,380.38 Typical High $1,905.46 | Professional | 50 · Both sides | $1,174.90 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $794.33 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $204.17 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $177.83 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $177.83 |
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,513.56 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,187.76 | Professional | None | $933.25 | $933.25 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $3,548.13 | Facility | None | $1,047.13 | $1,380.38 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,621.81 | Professional | None | $870.96 | $1,047.13 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,230.27 | Professional | None | $537.03 | $831.76 | $1,230.27 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $5,754.40 Typical High $23,442.29 | Facility | None | $1,000.00 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,398.83 | Professional | None | $977.24 | $1,288.25 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,168.69 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,168.69 | $14,125.38 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $2,290.87 | Professional | None | $630.96 | $977.24 | $2,290.87 |
Univera Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $4,677.35 | Facility | None | $630.96 | $870.96 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,230.27 | Professional | None | $630.96 | $831.76 | $1,230.27 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $691.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $660.69 Typical High $977.24 | Professional | 54 · Surgery only | $426.58 | $660.69 | $977.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $173.78 Typical High $263.03 | Professional | 55 · Aftercare only | $112.20 | $173.78 | $263.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $83.18 Typical High $123.03 | Professional | 56 · Pre-op care only | $53.70 | $83.18 | $123.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $575.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $371.54 | $575.44 | $851.14 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $501.19 Typical High $741.31 | Professional | 53 · Discontinued | $489.78 | $501.19 | $741.31 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $660.69 Typical High $977.24 | Professional | 54 · Surgery only | $426.58 | $660.69 | $977.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $173.78 Typical High $512.86 | Professional | 55 · Aftercare only | $112.20 | $173.78 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $83.18 Typical High $245.47 | Professional | 56 · Pre-op care only | $53.70 | $83.18 | $245.47 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $371.54 | $575.44 | $870.96 |
Where New York sits
The same service costs 7.9 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
$933
AK $3,890TX $490
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.