How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $10,965Professionalmedian $1,259 · 10th to 90th $955 to $2,399
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 $1,412.54 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,412.54 | $2,398.83 |
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 $977.24 Median $1,174.90 Typical High $2,238.72 | Professional | None | $977.24 | $1,174.90 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $3,388.44 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $1,412.54 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $190.55 Typical High $354.81 | Professional | 80 · Assistant surgeon | $158.49 | $190.55 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $316.23 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,258.93 Median $1,258.93 Typical High $4,466.84 | Professional | None | $1,258.93 | $1,258.93 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $4,677.35 | Facility | None | $1,348.96 | $2,290.87 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,445.44 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,659.59 | Professional | None | $794.33 | $1,047.13 | $1,659.59 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,778.28 | $3,162.28 |
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 $954.99 Median $1,412.54 Typical High $3,630.78 | Professional | None | $954.99 | $1,412.54 | $3,630.78 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $4,466.84 | Facility | None | $851.14 | $1,148.15 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,659.59 | Professional | None | $794.33 | $1,047.13 | $1,659.59 |
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 $812.83 | Professional | 52 · Reduced service | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $741.31 | $977.24 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $74.13 Typical High $120.23 | Professional | 55 · Aftercare only | $56.23 | $74.13 | $120.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $154.88 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $1,445.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $741.31 | $977.24 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $162.18 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $162.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $97.72 Typical High $208.93 | Professional | 56 · Pre-op care only | $72.44 | $97.72 | $208.93 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $912.01 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $676.08 | $912.01 | $1,445.44 |
Where New York sits
The same service costs 5.4 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
$1,288
AK $4,898TX $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.