How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,047 to $11,220Professionalmedian $955 · 10th to 90th $759 to $1,950
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 $1,122.02 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,258.93 | $1,862.09 |
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 $794.33 Median $933.25 Typical High $1,737.80 | Professional | None | $794.33 | $933.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $2,630.27 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $588.84 Typical High $1,096.48 | Professional | 62 · Two surgeons | $501.19 | $588.84 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $281.84 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $245.47 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $245.47 |
CDPHP Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $851.14 Median $1,122.02 Typical High $3,801.89 | Professional | None | $851.14 | $1,122.02 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $3,548.13 | Facility | None | $1,023.29 | $1,258.93 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,778.28 | Professional | None | $933.25 | $1,071.52 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,548.82 | Professional | None | $691.83 | $851.14 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $4,786.30 | Facility | None | $1,071.52 | $1,071.52 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,348.96 | $2,398.83 |
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 $724.44 Median $1,023.29 Typical High $2,691.53 | Professional | None | $724.44 | $1,023.29 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $870.96 Typical High $3,548.13 | Facility | None | $812.83 | $870.96 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,548.82 | Professional | None | $691.83 | $851.14 | $1,548.82 |
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 $562.34 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $891.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $630.96 | $776.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $144.54 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $128.82 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Professional | 53 · Discontinued | $501.19 | $660.69 | $1,000.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $630.96 | $776.25 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $173.78 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $173.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $154.88 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $154.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $1,288.25 |
Where New York sits
The same service costs 6.8 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
$1,000
AK $3,981TX $589
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.