How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $9,772Professionalmedian $813 · 10th to 90th $661 to $1,413
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 $870.96 Median $870.96 Typical High $891.25 | Professional | None | $870.96 | $870.96 | $891.25 |
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 $676.08 Median $794.33 Typical High $1,148.15 | Professional | None | $676.08 | $794.33 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,174.90 Typical High $1,698.24 | Professional | 50 · Both sides | $1,000.00 | $1,174.90 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $724.44 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $181.97 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $158.49 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $158.49 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,380.38 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,949.84 | Professional | None | $851.14 | $851.14 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,258.93 Typical High $3,311.31 | Facility | None | $954.99 | $1,258.93 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,445.44 | Professional | None | $794.33 | $933.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,122.02 | Professional | None | $489.78 | $758.58 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $870.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $2,187.76 | Professional | None | $891.25 | $1,174.90 | $2,187.76 |
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 $562.34 Median $870.96 Typical High $2,089.30 | Professional | None | $562.34 | $870.96 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $3,467.37 | Facility | None | $575.44 | $794.33 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,122.02 | Professional | None | $575.44 | $758.58 | $1,122.02 |
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 $436.52 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $616.60 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $588.84 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $158.49 Typical High $234.42 | Professional | 55 · Aftercare only | $102.33 | $158.49 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $75.86 Typical High $112.20 | Professional | 56 · Pre-op care only | $48.98 | $75.86 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $512.86 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $331.13 | $512.86 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $457.09 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $588.84 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $158.49 Typical High $467.74 | Professional | 55 · Aftercare only | $102.33 | $158.49 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $75.86 Typical High $223.87 | Professional | 56 · Pre-op care only | $48.98 | $75.86 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $512.86 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $331.13 | $512.86 | $794.33 |
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
$832
AK $3,467TX $437
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.