How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,349 to $10,471Professionalmedian $1,047 · 10th to 90th $851 to $1,778
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 $1,905.46 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,905.46 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,174.90 | $1,202.26 |
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 $891.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $891.25 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,137.96 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $891.25 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $199.53 |
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,513.56 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,023.29 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $3,981.07 | Facility | None | $1,174.90 | $1,659.59 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,230.27 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,513.56 | Professional | None | $645.65 | $1,000.00 | $1,513.56 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $36,307.81 | Facility | None | $4,786.30 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,737.80 | $2,818.38 |
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 $707.95 Median $1,071.52 Typical High $2,570.40 | Professional | None | $707.95 | $1,071.52 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $851.14 Typical High $4,570.88 | Facility | None | $758.58 | $851.14 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,513.56 | Professional | None | $758.58 | $954.99 | $1,513.56 |
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 $588.84 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $588.84 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $794.33 Typical High $1,258.93 | Professional | 54 · Surgery only | $512.86 | $794.33 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $208.93 Typical High $338.84 | Professional | 55 · Aftercare only | $134.90 | $208.93 | $338.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $162.18 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $691.83 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $446.68 | $691.83 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $616.60 Typical High $891.25 | Professional | 53 · Discontinued | $602.56 | $616.60 | $891.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $794.33 Typical High $1,174.90 | Professional | 54 · Surgery only | $512.86 | $794.33 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $208.93 Typical High $602.56 | Professional | 55 · Aftercare only | $134.90 | $208.93 | $602.56 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $288.40 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $446.68 | $691.83 | $1,023.29 |
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
$1,072
AK $4,571TX $575
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.