How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,023 to $10,000Professionalmedian $912 · 10th to 90th $724 to $1,905
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 $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,202.26 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,659.59 | Professional | None | $776.25 | $912.01 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,348.96 Typical High $2,511.89 | Professional | 50 · Both sides | $1,148.15 | $1,348.96 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $1,047.13 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $269.15 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $234.42 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $234.42 |
CDPHP Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $812.83 Median $1,096.48 Typical High $3,715.35 | Professional | None | $812.83 | $1,096.48 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,230.27 Typical High $3,467.37 | Facility | None | $977.24 | $1,230.27 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,698.24 | Professional | None | $954.99 | $1,047.13 | $1,698.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,513.56 | Professional | None | $660.69 | $812.83 | $1,513.56 |
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 $1,348.96 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,348.96 | $2,344.23 |
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 $691.83 Median $1,000.00 Typical High $2,630.27 | Professional | None | $691.83 | $1,000.00 | $2,630.27 |
Univera Setting Facility Modifier None Typical Low $776.25 Median $831.76 Typical High $3,467.37 | Facility | None | $776.25 | $831.76 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,479.11 | Professional | None | $660.69 | $812.83 | $1,479.11 |
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 $537.03 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $831.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $1,412.54 | Professional | 54 · Surgery only | $602.56 | $741.31 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $138.04 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $138.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $123.03 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $123.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $630.96 Typical High $954.99 | Professional | 53 · Discontinued | $489.78 | $630.96 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $1,348.96 | Professional | 54 · Surgery only | $602.56 | $741.31 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $165.96 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $165.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $147.91 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $147.91 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $1,230.27 |
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· 45th of 51
$955
AK $3,802TX $575
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.