How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,479 to $11,749Professionalmedian $1,445 · 10th to 90th $1,148 to $2,455
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 $6,309.57 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,309.57 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,570.88 | Professional | None | $1,513.56 | $1,513.56 | $4,570.88 |
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 $1,202.26 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,412.54 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,137.96 Typical High $2,951.21 | Professional | 50 · Both sides | $1,819.70 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,230.27 |
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 $275.42 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $275.42 |
CDPHP Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,737.80 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $9,332.54 | Professional | None | $1,445.44 | $1,445.44 | $9,332.54 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $5,128.61 | Facility | None | $1,513.56 | $1,778.28 | $5,128.61 |
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 $1,905.46 | Professional | None | $831.76 | $1,258.93 | $1,905.46 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,513.56 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,089.30 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $3,715.35 | Professional | None | $954.99 | $1,513.56 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,348.96 Typical High $8,128.31 | Facility | None | $977.24 | $1,348.96 | $8,128.31 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,905.46 | Professional | None | $977.24 | $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 $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
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 $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
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 $1,513.56 | Professional | 54 · Surgery only | $660.69 | $1,000.00 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $263.03 Typical High $398.11 | Professional | 55 · Aftercare only | $173.78 | $263.03 | $398.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $125.89 Typical High $190.55 | Professional | 56 · Pre-op care only | $83.18 | $125.89 | $190.55 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $870.96 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $575.44 | $870.96 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $776.25 Typical High $1,148.15 | Professional | 53 · Discontinued | $758.58 | $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 $794.33 | Professional | 55 · Aftercare only | $173.78 | $263.03 | $794.33 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $125.89 Typical High $380.19 | Professional | 56 · Pre-op care only | $83.18 | $125.89 | $380.19 |
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 8.7 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
$1,445
AK $5,888TX $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.