How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,479 to $15,488Professionalmedian $1,230 · 10th to 90th $955 to $2,042
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 $10,964.78 | Facility | None | $1,905.46 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,288.25 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,047.13 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $269.15 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $234.42 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $15,488.17 Typical High $32,359.37 | Facility | None | $1,513.56 | $15,488.17 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,230.27 | $2,818.38 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $4,570.88 | Facility | None | $1,258.93 | $1,819.70 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,380.38 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,659.59 | Professional | None | $724.44 | $1,122.02 | $1,659.59 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,445.44 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $3,019.95 | Professional | None | $851.14 | $1,288.25 | $3,019.95 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $954.99 Typical High $8,912.51 | Facility | None | $851.14 | $954.99 | $8,912.51 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,659.59 | Professional | None | $851.14 | $1,047.13 | $1,659.59 |
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 $645.65 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $870.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $562.34 | $870.96 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $371.54 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $371.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $112.20 Typical High $177.83 | Professional | 56 · Pre-op care only | $72.44 | $112.20 | $177.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $977.24 | Professional | 53 · Discontinued | $660.69 | $660.69 | $977.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $870.96 Typical High $1,318.26 | Professional | 54 · Surgery only | $562.34 | $870.96 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $676.08 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $676.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $112.20 Typical High $316.23 | Professional | 56 · Pre-op care only | $72.44 | $112.20 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $1,148.15 |
Where New York sits
The same service costs 7.6 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· 45th of 51
$1,230
AK $5,129TX $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.