How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,148 to $9,333Professionalmedian $457 · 10th to 90th $372 to $1,023
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,318.26 | Professional | None | $602.56 | $602.56 | $1,318.26 |
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 $371.54 Median $436.52 Typical High $891.25 | Professional | None | $371.54 | $436.52 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $645.65 Typical High $1,348.96 | Professional | 50 · Both sides | $549.54 | $645.65 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $275.42 Typical High $562.34 | Professional | 62 · Two surgeons | $234.42 | $275.42 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $69.18 Typical High $141.25 | Professional | 80 · Assistant surgeon | $58.88 | $69.18 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $60.26 Typical High $125.89 | Professional | AS · PA/NP assist | $51.29 | $60.26 | $125.89 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $5,623.41 | Facility | None | $954.99 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,949.84 | Professional | None | $436.52 | $537.03 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,862.09 | Facility | None | $537.03 | $891.25 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $912.01 | Professional | None | $537.03 | $588.84 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $812.83 | Professional | None | $338.84 | $436.52 | $812.83 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,230.27 | Professional | None | $707.95 | $741.31 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,348.96 | Professional | None | $346.74 | $524.81 | $1,348.96 |
Univera Setting Facility Modifier None Typical Low $288.40 Median $588.84 Typical High $1,862.09 | Facility | None | $288.40 | $588.84 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $724.44 | Professional | None | $281.84 | $436.52 | $724.44 |
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 $302.00 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $724.44 | Professional | 54 · Surgery only | $309.03 | $398.11 | $724.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $81.28 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $81.28 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $81.28 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $354.81 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $269.15 | $354.81 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $338.84 Typical High $512.86 | Professional | 53 · Discontinued | $257.04 | $338.84 | $512.86 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $645.65 | Professional | 54 · Surgery only | $251.19 | $398.11 | $645.65 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $43.65 Typical High $72.44 | Professional | 55 · Aftercare only | $28.18 | $43.65 | $72.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $72.44 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $72.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $575.44 |
Where New York sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$468
AK $2,042UT $372
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.