How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,259 to $10,715Professionalmedian $813 · 10th to 90th $646 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 $831.76 Median $831.76 Typical High $933.25 | Professional | None | $831.76 | $831.76 | $933.25 |
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 $645.65 Median $758.58 Typical High $1,148.15 | Professional | None | $645.65 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,148.15 Typical High $1,778.28 | Professional | 50 · Both sides | $977.24 | $1,148.15 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $724.44 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $181.97 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $154.88 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $154.88 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,479.11 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,949.84 | Professional | None | $870.96 | $870.96 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $3,548.13 | Facility | None | $933.25 | $1,148.15 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,548.82 | Professional | None | $831.76 | $870.96 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,148.15 | Professional | None | $501.19 | $812.83 | $1,148.15 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $2,137.96 | Professional | None | $891.25 | $933.25 | $2,137.96 |
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 $602.56 Median $870.96 Typical High $2,137.96 | Professional | None | $602.56 | $870.96 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $3,981.07 | Facility | None | $588.84 | $831.76 | $3,981.07 |
Univera Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
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 $416.87 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $645.65 Typical High $912.01 | Professional | 54 · Surgery only | $389.05 | $645.65 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $169.82 Typical High $239.88 | Professional | 55 · Aftercare only | $104.71 | $169.82 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $81.28 Typical High $114.82 | Professional | 56 · Pre-op care only | $50.12 | $81.28 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $562.34 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $338.84 | $562.34 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $446.68 Typical High $660.69 | Professional | 53 · Discontinued | $436.52 | $446.68 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $645.65 Typical High $912.01 | Professional | 54 · Surgery only | $389.05 | $645.65 | $912.01 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $169.82 Typical High $478.63 | Professional | 55 · Aftercare only | $104.71 | $169.82 | $478.63 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $81.28 Typical High $223.87 | Professional | 56 · Pre-op care only | $50.12 | $81.28 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $338.84 | $562.34 | $831.76 |
Where New York sits
The same service costs 8.1 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
$813
AK $3,631TX $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.