How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $10,965Professionalmedian $1,175 · 10th to 90th $891 to $2,291
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 $1,318.26 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,318.26 | $2,570.40 |
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 $912.01 Median $1,096.48 Typical High $2,089.30 | Professional | None | $912.01 | $1,096.48 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $3,162.28 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $1,318.26 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $331.13 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $295.12 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $295.12 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $1,174.90 Median $1,202.26 Typical High $4,168.69 | Professional | None | $1,174.90 | $1,202.26 | $4,168.69 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $4,265.80 | Facility | None | $1,230.27 | $2,137.96 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,318.26 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,548.82 | Professional | None | $741.31 | $977.24 | $1,548.82 |
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 $1,380.38 Median $1,380.38 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,380.38 | $2,951.21 |
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 $891.25 Median $1,318.26 Typical High $3,388.44 | Professional | None | $891.25 | $1,318.26 | $3,388.44 |
Univera Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $4,786.30 | Facility | None | $794.33 | $1,047.13 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,548.82 | Professional | None | $741.31 | $977.24 | $1,548.82 |
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 $660.69 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $912.01 Typical High $1,479.11 | Professional | 54 · Surgery only | $691.83 | $912.01 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $112.20 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $144.54 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $144.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $812.83 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $630.96 | $812.83 | $1,348.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $912.01 Typical High $1,479.11 | Professional | 54 · Surgery only | $691.83 | $912.01 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $70.79 Typical High $151.36 | Professional | 55 · Aftercare only | $52.48 | $70.79 | $151.36 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $194.98 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $851.14 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $630.96 | $851.14 | $1,348.96 |
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· 48th of 51
$1,202
AK $4,467TX $832
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.