How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $9,772Professionalmedian $589 · 10th to 90th $479 to $1,023
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 $1,819.70 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | None | $630.96 | $630.96 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $831.76 | Professional | None | $489.78 | $575.44 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $870.96 Typical High $1,230.27 | Professional | 50 · Both sides | $724.44 | $870.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $363.08 Typical High $524.81 | Professional | 62 · Two surgeons | $309.03 | $363.08 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $91.20 Typical High $131.83 | Professional | 80 · Assistant surgeon | $77.62 | $91.20 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $81.28 Typical High $114.82 | Professional | AS · PA/NP assist | $67.61 | $81.28 | $114.82 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,348.96 | Professional | None | $616.60 | $616.60 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $2,454.71 | Facility | None | $645.65 | $851.14 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,071.52 | Professional | None | $575.44 | $707.95 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $831.76 | Professional | None | $354.81 | $562.34 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $4,786.30 Typical High $5,754.40 | Facility | None | $616.60 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,584.89 | Professional | None | $645.65 | $794.33 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,513.56 | Professional | None | $426.58 | $645.65 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $2,818.38 | Facility | None | $416.87 | $575.44 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $831.76 | Professional | None | $416.87 | $562.34 | $831.76 |
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 $316.23 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $707.95 | Professional | 54 · Surgery only | $281.84 | $446.68 | $707.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $186.21 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $56.23 Typical High $89.13 | Professional | 56 · Pre-op care only | $35.48 | $56.23 | $89.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $616.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $478.63 | Professional | 53 · Discontinued | $323.59 | $331.13 | $478.63 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $446.68 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $331.13 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $56.23 Typical High $158.49 | Professional | 56 · Pre-op care only | $35.48 | $56.23 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $575.44 |
Where New York sits
The same service costs 7.8 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
$603
AK $2,570TX $331
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.