How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,445 to $14,454Professionalmedian $871 · 10th to 90th $708 to $1,479
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 $912.01 Median $912.01 Typical High $933.25 | Professional | None | $912.01 | $912.01 | $933.25 |
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 $724.44 Median $851.14 Typical High $1,202.26 | Professional | None | $724.44 | $851.14 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,288.25 Typical High $1,778.28 | Professional | 50 · Both sides | $1,096.48 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $758.58 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $165.96 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $165.96 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $7,762.47 Typical High $15,488.17 | Facility | None | $2,238.72 | $7,762.47 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $2,041.74 | Professional | None | $891.25 | $891.25 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $3,467.37 | Facility | None | $1,000.00 | $1,513.56 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,548.82 | Professional | None | $831.76 | $1,000.00 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,174.90 | Professional | None | $512.86 | $794.33 | $1,174.90 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,290.87 | Professional | None | $933.25 | $1,348.96 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $2,187.76 | Professional | None | $602.56 | $912.01 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $4,466.84 | Facility | None | $602.56 | $831.76 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,174.90 | Professional | None | $602.56 | $794.33 | $1,174.90 |
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 $457.09 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $660.69 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $933.25 | Professional | 54 · Surgery only | $407.38 | $630.96 | $933.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $165.96 Typical High $245.47 | Professional | 55 · Aftercare only | $107.15 | $165.96 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $79.43 Typical High $117.49 | Professional | 56 · Pre-op care only | $51.29 | $79.43 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $549.54 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $354.81 | $549.54 | $812.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $691.83 | Professional | 53 · Discontinued | $467.74 | $478.63 | $691.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $933.25 | Professional | 54 · Surgery only | $407.38 | $630.96 | $933.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $165.96 Typical High $489.78 | Professional | 55 · Aftercare only | $107.15 | $165.96 | $489.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $79.43 Typical High $234.42 | Professional | 56 · Pre-op care only | $51.29 | $79.43 | $234.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $549.54 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $354.81 | $549.54 | $831.76 |
Where New York sits
The same service costs 13.8 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
$891
AK $3,631TX $263
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.