How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,514 to $13,183Professionalmedian $1,622 · 10th to 90th $1,288 to $2,692
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 $2,089.30 Median $6,309.57 Typical High $12,022.64 | Facility | None | $2,089.30 | $6,309.57 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,348.96 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,398.83 Typical High $3,311.31 | Professional | 50 · Both sides | $2,041.74 | $2,398.83 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,412.54 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $309.03 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $309.03 |
CDPHP Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $15,135.61 Typical High $30,902.95 | Facility | None | $1,737.80 | $15,135.61 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,630.78 | Professional | None | $1,621.81 | $1,621.81 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $5,754.40 | Facility | None | $1,584.89 | $2,344.23 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,513.56 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,137.96 | Professional | None | $933.25 | $1,412.54 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,698.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $4,168.69 | Professional | None | $1,737.80 | $1,778.28 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,071.52 | $1,698.24 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $7,943.28 | Facility | None | $1,096.48 | $1,513.56 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,412.54 | $2,137.96 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,819.70 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $478.63 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $478.63 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $229.09 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $1,584.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $870.96 Typical High $1,288.25 | Professional | 53 · Discontinued | $851.14 | $870.96 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,698.24 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,698.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $870.96 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $870.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $416.87 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $416.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $1,513.56 |
Where New York sits
The same service costs 17.0 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· 44th of 51
$1,622
AK $6,607TX $389
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.