How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,445 to $14,125Professionalmedian $1,445 · 10th to 90th $1,148 to $2,399
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 $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,513.56 | $1,548.82 | $1,548.82 |
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 $1,230.27 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,137.96 Typical High $2,884.03 | Professional | 50 · Both sides | $1,819.70 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,202.26 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $309.03 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $269.15 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,778.28 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,445.44 | $3,388.44 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,621.81 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,584.89 | $2,511.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $2,041.74 | Professional | None | $831.76 | $1,258.93 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,000.00 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,258.93 | $3,311.31 |
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 $912.01 Median $1,513.56 Typical High $3,548.13 | Professional | None | $912.01 | $1,513.56 | $3,548.13 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,348.96 Typical High $4,365.16 | Facility | None | $977.24 | $1,348.96 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,905.46 | Professional | None | $831.76 | $1,258.93 | $1,905.46 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,000.00 Typical High $1,621.81 | Professional | 54 · Surgery only | $660.69 | $1,000.00 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $263.03 Typical High $436.52 | Professional | 55 · Aftercare only | $173.78 | $263.03 | $436.52 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $125.89 Typical High $204.17 | Professional | 56 · Pre-op care only | $83.18 | $125.89 | $204.17 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $870.96 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $575.44 | $870.96 | $1,412.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $1,148.15 | Professional | 53 · Discontinued | $776.25 | $776.25 | $1,148.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,000.00 Typical High $1,513.56 | Professional | 54 · Surgery only | $660.69 | $1,000.00 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $263.03 Typical High $776.25 | Professional | 55 · Aftercare only | $173.78 | $263.03 | $776.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $125.89 Typical High $371.54 | Professional | 56 · Pre-op care only | $83.18 | $125.89 | $371.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $870.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $575.44 | $870.96 | $1,348.96 |
Where New York sits
The same service costs 8.9 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· 41st of 51
$1,445
AK $6,026TX $676
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.