How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $11,220Professionalmedian $1,047 · 10th to 90th $832 to $2,188
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 $1,258.93 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,318.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $2,041.74 | Professional | None | $870.96 | $1,023.29 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $3,090.30 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $645.65 Typical High $1,288.25 | Professional | 62 · Two surgeons | $549.54 | $645.65 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $165.96 Typical High $346.74 | Professional | 80 · Assistant surgeon | $131.83 | $165.96 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $288.40 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $288.40 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,047.13 Median $1,412.54 Typical High $4,365.16 | Professional | None | $1,047.13 | $1,412.54 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $4,073.80 | Facility | None | $1,000.00 | $1,258.93 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,318.26 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,698.24 | Professional | None | $741.31 | $954.99 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,786.30 | Facility | None | $1,047.13 | $1,047.13 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,412.54 | $2,754.23 |
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 $851.14 Median $1,148.15 Typical High $3,235.94 | Professional | None | $851.14 | $1,148.15 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,023.29 Typical High $3,715.35 | Facility | None | $891.25 | $1,023.29 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,698.24 | Professional | None | $741.31 | $954.99 | $1,698.24 |
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 $616.60 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $870.96 Typical High $1,548.82 | Professional | 54 · Surgery only | $691.83 | $870.96 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $151.36 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $134.90 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $794.33 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $630.96 | $794.33 | $1,412.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $758.58 Typical High $1,071.52 | Professional | 53 · Discontinued | $549.54 | $758.58 | $1,071.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $870.96 Typical High $1,548.82 | Professional | 54 · Surgery only | $691.83 | $870.96 | $1,548.82 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $190.55 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $169.82 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $169.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $794.33 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $630.96 | $794.33 | $1,412.54 |
Where New York sits
The same service costs 6.6 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
$1,096
AK $4,365TX $661
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.