How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,259 to $11,220Professionalmedian $692 · 10th to 90th $537 to $1,413
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $2,137.96 | Professional | None | $630.96 | $954.99 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,318.26 | Professional | None | $549.54 | $645.65 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $977.24 Typical High $1,995.26 | Professional | 50 · Both sides | $831.76 | $977.24 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $407.38 Typical High $831.76 | Professional | 62 · Two surgeons | $346.74 | $407.38 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $213.80 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $177.83 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $177.83 |
CDPHP Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $691.83 Median $831.76 Typical High $2,691.53 | Professional | None | $691.83 | $831.76 | $2,691.53 |
Emblem Health Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,630.27 | Facility | None | $676.08 | $1,174.90 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,288.25 | Professional | None | $691.83 | $794.33 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,023.29 | Professional | None | $478.63 | $602.56 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,786.30 | Facility | None | $707.95 | $707.95 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,737.80 | Professional | None | $794.33 | $794.33 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,905.46 | Professional | None | $524.81 | $891.25 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $660.69 Typical High $2,238.72 | Facility | None | $524.81 | $660.69 | $2,238.72 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $933.25 | Professional | None | $478.63 | $602.56 | $933.25 |
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 $309.03 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $63.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $524.81 Typical High $891.25 | Professional | 54 · Surgery only | $416.87 | $524.81 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $85.11 Typical High $147.91 | Professional | 55 · Aftercare only | $67.61 | $85.11 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $72.44 Typical High $125.89 | Professional | 56 · Pre-op care only | $57.54 | $72.44 | $125.89 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $446.68 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $354.81 | $446.68 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $478.63 Typical High $724.44 | Professional | 53 · Discontinued | $363.08 | $478.63 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $537.03 Typical High $870.96 | Professional | 54 · Surgery only | $416.87 | $537.03 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $194.98 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $165.96 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $354.81 | $457.09 | $758.58 |
Where New York sits
The same service costs 6.9 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· 44th of 51
$724
AK $2,884TX $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.