How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $10,965Professionalmedian $1,349 · 10th to 90th $1,023 to $2,630
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 $1,548.82 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,548.82 | $2,951.21 |
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 $1,071.52 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,288.25 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $3,630.78 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,513.56 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $389.05 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $338.84 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,348.96 Median $1,380.38 Typical High $4,897.79 | Professional | None | $1,348.96 | $1,380.38 | $4,897.79 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,041.74 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,548.82 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,862.09 | Professional | None | $870.96 | $1,148.15 | $1,862.09 |
MVP Health Care Setting Facility Modifier None Typical Low $1,479.11 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,479.11 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,659.59 | $3,467.37 |
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 $1,023.29 Median $1,513.56 Typical High $3,981.07 | Professional | None | $1,023.29 | $1,513.56 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $5,011.87 | Facility | None | $912.01 | $1,230.27 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,862.09 | Professional | None | $870.96 | $1,148.15 | $1,862.09 |
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 $776.25 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $776.25 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,071.52 Typical High $1,778.28 | Professional | 54 · Surgery only | $812.83 | $1,071.52 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $134.90 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $102.33 Typical High $173.78 | Professional | 56 · Pre-op care only | $77.62 | $102.33 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $954.99 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $724.44 | $954.99 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,096.48 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,096.48 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $83.18 Typical High $177.83 | Professional | 55 · Aftercare only | $60.26 | $83.18 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $223.87 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,000.00 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $724.44 | $1,000.00 | $1,548.82 |
Where New York sits
The same service costs 5.5 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
$1,380
AK $5,248TX $955
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.