How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,380 to $11,749Professionalmedian $1,047 · 10th to 90th $794 to $2,089
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 $11,481.54 | Facility | None | $1,819.70 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,348.96 | $2,290.87 |
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 $812.83 Median $977.24 Typical High $1,949.84 | Professional | None | $812.83 | $977.24 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,479.11 Typical High $2,951.21 | Professional | 50 · Both sides | $1,230.27 | $1,479.11 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $616.60 Typical High $1,230.27 | Professional | 62 · Two surgeons | $512.86 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $316.23 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $275.42 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $275.42 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
CDPHP Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,659.59 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $3,801.89 | Professional | None | $1,047.13 | $1,148.15 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $3,630.78 | Facility | None | $1,023.29 | $1,445.44 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,202.26 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,445.44 | Professional | None | $660.69 | $870.96 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,202.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,148.15 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $3,019.95 | Professional | None | $794.33 | $1,174.90 | $3,019.95 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $954.99 Typical High $3,801.89 | Facility | None | $707.95 | $954.99 | $3,801.89 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,445.44 | Professional | None | $660.69 | $870.96 | $1,445.44 |
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 $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $812.83 Typical High $1,380.38 | Professional | 54 · Surgery only | $616.60 | $812.83 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $61.66 Typical High $102.33 | Professional | 55 · Aftercare only | $46.77 | $61.66 | $102.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $79.43 Typical High $131.83 | Professional | 56 · Pre-op care only | $60.26 | $79.43 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $741.31 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $562.34 | $741.31 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $851.14 Typical High $1,348.96 | Professional | 54 · Surgery only | $616.60 | $851.14 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $63.10 Typical High $134.90 | Professional | 55 · Aftercare only | $46.77 | $63.10 | $134.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $81.28 Typical High $173.78 | Professional | 56 · Pre-op care only | $60.26 | $81.28 | $173.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $758.58 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $562.34 | $758.58 | $1,202.26 |
Where New York sits
The same service costs 5.1 times more in Wisconsin 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· 50th of 51
$1,072
WI $4,677TX $912
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.