How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,349 to $11,482Professionalmedian $1,148 · 10th to 90th $912 to $2,570
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 $1,819.70 Median $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,621.81 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,290.87 | Professional | None | $977.24 | $1,148.15 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,698.24 Typical High $3,388.44 | Professional | 50 · Both sides | $1,445.44 | $1,698.24 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,445.44 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $363.08 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $316.23 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $316.23 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,513.56 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $5,011.87 | Professional | None | $891.25 | $1,288.25 | $5,011.87 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $4,073.80 | Facility | None | $1,071.52 | $1,288.25 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,318.26 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,479.11 | Professional | None | $776.25 | $1,023.29 | $1,479.11 |
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 $1,258.93 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,258.93 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $3,162.28 | Professional | None | $851.14 | $1,174.90 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $3,890.45 | Facility | None | $851.14 | $1,071.52 | $3,890.45 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,445.44 | Professional | None | $776.25 | $1,023.29 | $1,445.44 |
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 $707.95 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,071.52 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $213.80 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,148.15 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $676.08 | $870.96 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $218.78 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $218.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $100.00 Typical High $158.49 | Professional | 56 · Pre-op care only | $77.62 | $100.00 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $758.58 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $588.84 | $758.58 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $758.58 Typical High $1,202.26 | Professional | 53 · Discontinued | $575.44 | $758.58 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $1,258.93 | Professional | 54 · Surgery only | $676.08 | $870.96 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $316.23 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $316.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $100.00 Typical High $229.09 | Professional | 56 · Pre-op care only | $77.62 | $100.00 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $758.58 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $588.84 | $758.58 | $1,122.02 |
Where New York sits
The same service costs 6.8 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· 44th of 51
$1,202
AK $4,786TX $708
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.