How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,622 to $14,454Professionalmedian $1,380 · 10th to 90th $1,096 to $2,754
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 $10,471.29 | Facility | None | $1,819.70 | $5,623.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,698.24 | $3,235.94 |
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 $1,096.48 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,288.25 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,949.84 Typical High $3,311.31 | Professional | 50 · Both sides | $1,659.59 | $1,949.84 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $812.83 Typical High $1,412.54 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $354.81 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $309.03 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $309.03 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,737.80 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,621.81 | $1,621.81 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $5,888.44 | Facility | None | $1,479.11 | $1,862.09 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,778.28 | $1,778.28 | $2,951.21 |
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 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Highmark BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $54,954.09 | Facility | None | $4,786.30 | $5,754.40 | $54,954.09 |
MVP Health Care Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,905.46 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,318.26 | $4,073.80 | $15,488.17 |
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 $2,137.96 Typical High $6,456.54 | Facility | None | $1,096.48 | $2,137.96 | $6,456.54 |
Univera 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 |
14 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 $346.74 | Professional | 53 · Discontinued | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,698.24 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $457.09 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $457.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $213.80 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,698.24 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,698.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $457.09 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $457.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $213.80 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $1,479.11 |
Where New York sits
The same service costs 7.8 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
$1,380
AK $6,761TX $871
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.