How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,349 to $11,220Professionalmedian $1,175 · 10th to 90th $955 to $1,995
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 $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,230.27 | $2,344.23 |
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 $977.24 Median $1,148.15 Typical High $1,621.81 | Professional | None | $977.24 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,398.83 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,000.00 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $223.87 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $223.87 |
CDPHP 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 |
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 $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $912.01 Median $1,318.26 Typical High $4,168.69 | Facility | None | $912.01 | $1,318.26 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,258.93 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,548.82 | Professional | None | $676.08 | $1,023.29 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,819.70 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,884.03 | Professional | None | $776.25 | $1,230.27 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $794.33 Median $1,096.48 Typical High $5,248.07 | Facility | None | $794.33 | $1,096.48 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Professional | None | $794.33 | $1,023.29 | $1,548.82 |
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 $616.60 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 53 · Discontinued | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $891.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $794.33 Typical High $1,230.27 | Professional | 54 · Surgery only | $524.81 | $794.33 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $213.80 Typical High $323.59 | Professional | 55 · Aftercare only | $141.25 | $213.80 | $323.59 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $102.33 Typical High $154.88 | Professional | 56 · Pre-op care only | $67.61 | $102.33 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $691.83 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $467.74 | $691.83 | $1,071.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $630.96 Typical High $933.25 | Professional | 53 · Discontinued | $616.60 | $630.96 | $933.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $794.33 Typical High $1,230.27 | Professional | 54 · Surgery only | $524.81 | $794.33 | $1,230.27 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $213.80 Typical High $645.65 | Professional | 55 · Aftercare only | $141.25 | $213.80 | $645.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $102.33 Typical High $309.03 | Professional | 56 · Pre-op care only | $67.61 | $102.33 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $691.83 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $467.74 | $691.83 | $1,096.48 |
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· 45th of 51
$1,175
AK $4,786TX $550
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.