How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,233Professionalmedian $550 · 10th to 90th $447 to $891
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | None | $630.96 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $891.25 | Professional | None | $446.68 | $524.81 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $794.33 Typical High $1,348.96 | Professional | 50 · Both sides | $676.08 | $794.33 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $331.13 Typical High $562.34 | Professional | 62 · Two surgeons | $281.84 | $331.13 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $85.11 Typical High $141.25 | Professional | 80 · Assistant surgeon | $72.44 | $85.11 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $125.89 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $125.89 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $5,888.44 | Facility | None | $2,089.30 | $3,019.95 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,174.90 | Professional | None | $512.86 | $512.86 | $1,174.90 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $724.44 Typical High $2,454.71 | Facility | None | $602.56 | $724.44 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,230.27 | Professional | None | $575.44 | $707.95 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $812.83 | Professional | None | $407.38 | $549.54 | $812.83 |
MVP Health Care Setting Facility Modifier None Typical Low $575.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $575.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $977.24 | Professional | None | $660.69 | $660.69 | $977.24 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $912.01 | Professional | None | $436.52 | $575.44 | $912.01 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $2,137.96 | Facility | None | $389.05 | $575.44 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $812.83 | Professional | None | $407.38 | $549.54 | $812.83 |
15 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 $316.23 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $478.63 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $501.19 Typical High $741.31 | Professional | 54 · Surgery only | $295.12 | $501.19 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $54.95 Typical High $81.28 | Professional | 55 · Aftercare only | $33.11 | $54.95 | $81.28 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $50.12 Typical High $74.13 | Professional | 56 · Pre-op care only | $29.51 | $50.12 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $446.68 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $416.87 Typical High $602.56 | Professional | 53 · Discontinued | $316.23 | $416.87 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $501.19 Typical High $741.31 | Professional | 54 · Surgery only | $295.12 | $501.19 | $741.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $54.95 Typical High $117.49 | Professional | 55 · Aftercare only | $33.11 | $54.95 | $117.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $50.12 Typical High $107.15 | Professional | 56 · Pre-op care only | $29.51 | $50.12 | $107.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $446.68 | $660.69 |
Where New York sits
The same service costs 5.9 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· 46th of 51
$562
AK $2,455TX $417
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.