How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $10,965Professionalmedian $1,288 · 10th to 90th $977 to $2,455
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,311.31 | Professional | None | $1,412.54 | $1,412.54 | $3,311.31 |
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 $1,023.29 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,230.27 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $3,388.44 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $630.96 | $776.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $363.08 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $316.23 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,288.25 Median $1,288.25 Typical High $4,365.16 | Professional | None | $1,288.25 | $1,288.25 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $4,786.30 | Facility | None | $1,412.54 | $1,862.09 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,548.82 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,778.28 | Professional | None | $831.76 | $1,148.15 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,513.56 | $3,235.94 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $3,715.35 | Professional | None | $1,023.29 | $1,445.44 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,174.90 Typical High $5,888.44 | Facility | None | $870.96 | $1,174.90 | $5,888.44 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,778.28 | Professional | None | $831.76 | $1,148.15 | $1,778.28 |
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 $707.95 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,071.52 Typical High $1,698.24 | Professional | 54 · Surgery only | $776.25 | $1,071.52 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $79.43 Typical High $128.82 | Professional | 55 · Aftercare only | $57.54 | $79.43 | $128.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $102.33 Typical High $165.96 | Professional | 56 · Pre-op care only | $74.13 | $102.33 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $954.99 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $691.83 | $954.99 | $1,548.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,071.52 Typical High $1,659.59 | Professional | 54 · Surgery only | $776.25 | $1,071.52 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $79.43 Typical High $169.82 | Professional | 55 · Aftercare only | $57.54 | $79.43 | $169.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $102.33 Typical High $213.80 | Professional | 56 · Pre-op care only | $74.13 | $102.33 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $691.83 | $954.99 | $1,513.56 |
Where New York sits
The same service costs 4.8 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
$1,288
AK $5,012TX $1,047
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.