How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,479 to $11,749Professionalmedian $1,259 · 10th to 90th $955 to $2,455
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 $1,905.46 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,905.46 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,890.45 | Professional | None | $1,412.54 | $1,412.54 | $3,890.45 |
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 $1,000.00 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,202.26 | $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 $630.96 Median $758.58 Typical High $1,412.54 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $190.55 Typical High $363.08 | Professional | 80 · Assistant surgeon | $158.49 | $190.55 | $363.08 |
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 Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
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 $2,238.72 Median $5,248.07 Typical High $10,715.19 | Facility | None | $2,238.72 | $5,248.07 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,466.84 | Professional | None | $1,288.25 | $1,288.25 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $4,677.35 | Facility | None | $1,380.38 | $2,344.23 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,445.44 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,737.80 | Professional | None | $812.83 | $1,071.52 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,445.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,445.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,621.81 | $1,621.81 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $3,715.35 | Professional | None | $954.99 | $1,412.54 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $4,073.80 | Facility | None | $851.14 | $1,148.15 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,737.80 | Professional | None | $812.83 | $1,071.52 | $1,737.80 |
10 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 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $1,659.59 | Professional | 54 · Surgery only | $741.31 | $977.24 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $74.13 Typical High $123.03 | Professional | 55 · Aftercare only | $56.23 | $74.13 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $158.49 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,023.29 Typical High $1,621.81 | Professional | 54 · Surgery only | $741.31 | $1,023.29 | $1,621.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $77.62 Typical High $162.18 | Professional | 55 · Aftercare only | $56.23 | $77.62 | $162.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $100.00 Typical High $208.93 | Professional | 56 · Pre-op care only | $72.44 | $100.00 | $208.93 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $933.25 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $676.08 | $933.25 | $1,445.44 |
Where New York sits
The same service costs 5.4 times more in Wisconsin 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· 49th of 51
$1,288
WI $5,248TX $977
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.