How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $10,965Professionalmedian $2,042 · 10th to 90th $1,585 to $3,890
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 $2,290.87 Median $2,290.87 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,290.87 | $4,265.80 |
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 $1,621.81 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,621.81 | $1,949.84 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,951.21 Typical High $5,370.32 | Professional | 50 · Both sides | $2,454.71 | $2,951.21 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,230.27 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,023.29 | $1,230.27 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $316.23 Typical High $575.44 | Professional | 80 · Assistant surgeon | $263.03 | $316.23 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $275.42 Typical High $501.19 | Professional | AS · PA/NP assist | $229.09 | $275.42 | $501.19 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $7,244.36 | Professional | None | $1,995.26 | $2,041.74 | $7,244.36 |
Emblem Health Setting Facility Modifier None Typical Low $1,905.46 Median $3,388.44 Typical High $6,918.31 | Facility | None | $1,905.46 | $3,388.44 | $6,918.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,290.87 | $3,981.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,659.59 | $2,754.23 |
MVP Health Care Setting Facility Modifier None Typical Low $2,238.72 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,238.72 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $5,011.87 | Professional | None | $2,187.76 | $2,187.76 | $5,011.87 |
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 $1,513.56 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,513.56 | $2,238.72 | $5,754.40 |
Univera Setting Facility Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $7,244.36 | Facility | None | $1,348.96 | $1,819.70 | $7,244.36 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,659.59 | $2,754.23 |
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 $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | 53 · Discontinued | $457.09 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,548.82 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,174.90 | $1,548.82 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $117.49 Typical High $194.98 | Professional | 55 · Aftercare only | $89.13 | $117.49 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $151.36 Typical High $251.19 | Professional | 56 · Pre-op care only | $114.82 | $151.36 | $251.19 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,412.54 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,412.54 | $2,344.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,621.81 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,174.90 | $1,621.81 | $2,511.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $120.23 Typical High $257.04 | Professional | 55 · Aftercare only | $89.13 | $120.23 | $257.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $154.88 Typical High $331.13 | Professional | 56 · Pre-op care only | $114.82 | $154.88 | $331.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,445.44 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,445.44 | $2,290.87 |
Where New York sits
The same service costs 5.1 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
$2,089
AK $7,762TX $1,514
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.