How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,047 to $10,965Professionalmedian $1,000 · 10th to 90th $776 to $1,950
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,022.64 | Facility | None | $1,698.24 | $6,309.57 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,778.28 | Professional | None | $794.33 | $954.99 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,445.44 Typical High $2,691.53 | Professional | 50 · Both sides | $1,202.26 | $1,445.44 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $1,122.02 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $154.88 Typical High $281.84 | Professional | 80 · Assistant surgeon | $128.82 | $154.88 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $251.19 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $251.19 |
CDPHP Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $3,388.44 | Professional | None | $1,000.00 | $1,023.29 | $3,388.44 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $3,801.89 | Facility | None | $1,047.13 | $1,698.24 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,230.27 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,412.54 | Professional | None | $660.69 | $912.01 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,047.13 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,047.13 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,318.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $2,951.21 | Professional | None | $812.83 | $1,148.15 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $912.01 Typical High $3,801.89 | Facility | None | $691.83 | $912.01 | $3,801.89 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,412.54 | Professional | None | $660.69 | $912.01 | $1,412.54 |
14 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 $562.34 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $851.14 Typical High $1,348.96 | Professional | 54 · Surgery only | $602.56 | $851.14 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $100.00 | Professional | 55 · Aftercare only | $45.71 | $64.57 | $100.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $81.28 Typical High $128.82 | Professional | 56 · Pre-op care only | $58.88 | $81.28 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $758.58 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $549.54 | $758.58 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $851.14 Typical High $1,318.26 | Professional | 54 · Surgery only | $602.56 | $851.14 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $131.83 | Professional | 55 · Aftercare only | $45.71 | $64.57 | $131.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $81.28 Typical High $169.82 | Professional | 56 · Pre-op care only | $58.88 | $81.28 | $169.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $758.58 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $549.54 | $758.58 | $1,174.90 |
Where New York sits
The same service costs 4.7 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· 47th of 51
$1,023
AK $3,981TX $851
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.