How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,413 to $10,965Professionalmedian $1,479 · 10th to 90th $1,202 to $2,512
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 $1,584.89 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,584.89 | $1,659.59 |
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 $1,258.93 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,238.72 Typical High $3,019.95 | Professional | 50 · Both sides | $1,905.46 | $2,238.72 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $794.33 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $316.23 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $281.84 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,737.80 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,548.13 | Professional | None | $1,513.56 | $1,513.56 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $5,370.32 | Facility | None | $1,047.13 | $1,659.59 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,659.59 | $2,630.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,995.26 | Professional | None | $870.96 | $1,318.26 | $1,995.26 |
MVP Health Care Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $977.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,412.54 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,073.80 Typical High $12,302.69 | Facility | None | $1,348.96 | $4,073.80 | $12,302.69 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $3,715.35 | Professional | None | $933.25 | $1,584.89 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $4,466.84 | Facility | None | $1,023.29 | $1,412.54 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,995.26 | Professional | None | $870.96 | $1,318.26 | $1,995.26 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,698.24 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $275.42 Typical High $446.68 | Professional | 55 · Aftercare only | $181.97 | $275.42 | $446.68 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $131.83 Typical High $213.80 | Professional | 56 · Pre-op care only | $87.10 | $131.83 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $912.01 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $602.56 | $912.01 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $812.83 Typical High $1,202.26 | Professional | 53 · Discontinued | $794.33 | $812.83 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,584.89 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $275.42 Typical High $812.83 | Professional | 55 · Aftercare only | $181.97 | $275.42 | $812.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $131.83 Typical High $389.05 | Professional | 56 · Pre-op care only | $87.10 | $131.83 | $389.05 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $912.01 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $602.56 | $912.01 | $1,412.54 |
Where New York sits
The same service costs 8.5 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· 42nd of 51
$1,514
AK $6,166TX $724
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.