How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,413 to $11,749Professionalmedian $1,202 · 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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,000.00 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,174.90 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,778.28 Typical High $2,454.71 | Professional | 50 · Both sides | $1,513.56 | $1,778.28 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,023.29 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $263.03 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $229.09 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $229.09 |
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 $7,762.47 Typical High $15,848.93 | Facility | None | $1,737.80 | $7,762.47 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,202.26 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $4,365.16 | Facility | None | $1,230.27 | $1,905.46 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,348.96 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $691.83 | $1,071.52 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,258.93 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,258.93 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,348.96 | $3,090.30 |
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 $812.83 Median $1,258.93 Typical High $2,951.21 | Professional | None | $812.83 | $1,258.93 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $4,897.79 | Facility | None | $812.83 | $1,122.02 | $4,897.79 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $812.83 | $1,071.52 | $1,584.89 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $933.25 | $933.25 | $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 $870.96 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $891.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $851.14 Typical High $1,258.93 | Professional | 54 · Surgery only | $549.54 | $851.14 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $338.84 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $338.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $107.15 Typical High $158.49 | Professional | 56 · Pre-op care only | $69.18 | $107.15 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $645.65 Typical High $954.99 | Professional | 53 · Discontinued | $630.96 | $645.65 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $851.14 Typical High $1,258.93 | Professional | 54 · Surgery only | $549.54 | $851.14 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $660.69 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $660.69 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $107.15 Typical High $316.23 | Professional | 56 · Pre-op care only | $69.18 | $107.15 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $1,122.02 |
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
$1,202
AK $5,012TX $575
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.