How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,380 to $10,471Professionalmedian $1,122 · 10th to 90th $891 to $1,862
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $2,290.87 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $676.08 Typical High $954.99 | Professional | 62 · Two surgeons | $575.44 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $239.88 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $213.80 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,630.78 Typical High $7,079.46 | Facility | None | $1,513.56 | $3,630.78 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,122.02 | $2,570.40 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $3,981.07 | Facility | None | $1,230.27 | $1,659.59 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,230.27 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,479.11 | Professional | None | $630.96 | $977.24 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,659.59 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,691.53 | Professional | None | $741.31 | $1,148.15 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $5,495.41 | Facility | None | $741.31 | $1,047.13 | $5,495.41 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,479.11 | Professional | None | $741.31 | $977.24 | $1,479.11 |
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 $575.44 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $575.44 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $501.19 | $776.25 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $331.13 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $158.49 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $870.96 | Professional | 53 · Discontinued | $588.84 | $602.56 | $870.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $776.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $501.19 | $776.25 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $588.84 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $588.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $281.84 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $1,047.13 |
Where New York sits
The same service costs 19.5 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
$1,122
AK $4,571TX $234
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.