How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,380 to $14,125Professionalmedian $955 · 10th to 90th $759 to $1,585
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 $5,754.40 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | None | $977.24 | $977.24 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,288.25 | Professional | None | $794.33 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,949.84 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $588.84 Typical High $812.83 | Professional | 62 · Two surgeons | $501.19 | $588.84 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $181.97 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $181.97 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,513.56 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,187.76 | Professional | None | $954.99 | $954.99 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $3,548.13 | Facility | None | $1,071.52 | $1,412.54 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $891.25 | $1,071.52 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,258.93 | Professional | None | $549.54 | $851.14 | $1,258.93 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,000.00 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,412.54 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $2,344.23 | Professional | None | $645.65 | $1,000.00 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $645.65 Median $891.25 Typical High $5,011.87 | Facility | None | $645.65 | $891.25 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Professional | None | $645.65 | $851.14 | $1,258.93 |
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 $489.78 Median $489.78 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $707.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $676.08 Typical High $1,071.52 | Professional | 54 · Surgery only | $436.52 | $676.08 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $177.83 Typical High $288.40 | Professional | 55 · Aftercare only | $114.82 | $177.83 | $288.40 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $85.11 Typical High $134.90 | Professional | 56 · Pre-op care only | $54.95 | $85.11 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $588.84 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $380.19 | $588.84 | $933.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $512.86 Typical High $758.58 | Professional | 53 · Discontinued | $501.19 | $512.86 | $758.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $676.08 Typical High $1,000.00 | Professional | 54 · Surgery only | $436.52 | $676.08 | $1,000.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $177.83 Typical High $512.86 | Professional | 55 · Aftercare only | $114.82 | $177.83 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $85.11 Typical High $245.47 | Professional | 56 · Pre-op care only | $54.95 | $85.11 | $245.47 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $588.84 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $380.19 | $588.84 | $891.25 |
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
$955
AK $3,981TX $501
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.