How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,349 to $14,125Professionalmedian $813 · 10th to 90th $661 to $1,380
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
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 $676.08 Median $794.33 Typical High $1,122.02 | Professional | None | $676.08 | $794.33 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,659.59 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $691.83 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $154.88 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $154.88 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,348.96 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,905.46 | Professional | None | $831.76 | $831.76 | $1,905.46 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,047.13 Typical High $3,235.94 | Facility | None | $891.25 | $1,047.13 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,445.44 | Professional | None | $776.25 | $933.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | None | $478.63 | $741.31 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $5,754.40 | Facility | None | $831.76 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $2,137.96 | Professional | None | $870.96 | $1,174.90 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $2,041.74 | Professional | None | $562.34 | $851.14 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $776.25 Typical High $4,073.80 | Facility | None | $562.34 | $776.25 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,096.48 | Professional | None | $562.34 | $741.31 | $1,096.48 |
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 $426.58 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $870.96 | Professional | 54 · Surgery only | $380.19 | $588.84 | $870.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $154.88 Typical High $229.09 | Professional | 55 · Aftercare only | $100.00 | $154.88 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $74.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $47.86 | $74.13 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $512.86 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $331.13 | $512.86 | $758.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $645.65 | Professional | 53 · Discontinued | $436.52 | $436.52 | $645.65 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $870.96 | Professional | 54 · Surgery only | $380.19 | $588.84 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $154.88 Typical High $457.09 | Professional | 55 · Aftercare only | $100.00 | $154.88 | $457.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $74.13 Typical High $218.78 | Professional | 56 · Pre-op care only | $47.86 | $74.13 | $218.78 |
Univera 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 |
Where New York sits
The same service costs 7.6 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
$832
AK $3,388TX $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.