How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,122 to $10,965Professionalmedian $1,585 · 10th to 90th $1,259 to $3,311
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 $2,089.30 Median $2,089.30 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,089.30 | $3,715.35 |
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 $1,318.26 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,584.89 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,344.23 Typical High $4,677.35 | Professional | 50 · Both sides | $1,949.84 | $2,344.23 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,949.84 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $501.19 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $218.78 Typical High $436.52 | Professional | AS · PA/NP assist | $181.97 | $218.78 | $436.52 |
CDPHP Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,698.24 Median $1,778.28 Typical High $6,025.60 | Professional | None | $1,698.24 | $1,778.28 | $6,025.60 |
Emblem Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $5,888.44 | Facility | None | $1,621.81 | $2,398.83 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,659.59 | $1,905.46 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,412.54 | $2,187.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
MVP Health Care Setting Facility Modifier None Typical Low $1,862.09 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,862.09 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,265.80 | Professional | None | $1,513.56 | $1,513.56 | $4,265.80 |
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 $1,258.93 Median $1,862.09 Typical High $4,897.79 | Professional | None | $1,258.93 | $1,862.09 | $4,897.79 |
Univera Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $6,456.54 | Facility | None | $1,122.02 | $1,513.56 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,412.54 | $2,187.76 |
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 $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | 53 · Discontinued | $416.87 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,288.25 Typical High $2,137.96 | Professional | 54 · Surgery only | $977.24 | $1,288.25 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $97.72 Typical High $158.49 | Professional | 55 · Aftercare only | $74.13 | $97.72 | $158.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $125.89 Typical High $204.17 | Professional | 56 · Pre-op care only | $95.50 | $125.89 | $204.17 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,174.90 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $891.25 | $1,174.90 | $1,905.46 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $977.24 | $1,348.96 | $2,137.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $102.33 Typical High $213.80 | Professional | 55 · Aftercare only | $74.13 | $102.33 | $213.80 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $131.83 Typical High $275.42 | Professional | 56 · Pre-op care only | $95.50 | $131.83 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,230.27 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $891.25 | $1,230.27 | $1,905.46 |
Where New York sits
The same service costs 5.8 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· 43rd of 51
$1,660
AK $6,457TX $1,122
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.