How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $14,454Professionalmedian $1,445 · 10th to 90th $1,175 to $3,162
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,621.81 | $1,778.28 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $15,488.17 | Facility | None | $1,862.09 | $8,709.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,412.54 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,089.30 Typical High $4,265.80 | Professional | 50 · Both sides | $1,778.28 | $2,089.30 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,778.28 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $223.87 Typical High $457.09 | Professional | 80 · Assistant surgeon | $190.55 | $223.87 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $398.11 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,380.38 Median $1,737.80 Typical High $7,762.47 | Professional | None | $1,380.38 | $1,737.80 | $7,762.47 |
Emblem Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $5,754.40 | Facility | None | $1,548.82 | $2,454.71 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,905.46 | $3,090.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,318.26 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,445.44 Median $4,786.30 Typical High $87,096.36 | Facility | None | $1,445.44 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,801.89 | Professional | None | $1,698.24 | $1,698.24 | $3,801.89 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,165.95 | Facility | None | $575.44 | $1,737.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,258.93 | $1,949.84 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $6,309.57 | Facility | None | $1,288.25 | $1,380.38 | $6,309.57 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,318.26 | $1,819.70 |
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 $812.83 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,258.93 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,698.24 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $257.04 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $213.80 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $977.24 Typical High $1,445.44 | Professional | 53 · Discontinued | $707.95 | $977.24 | $1,445.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,584.89 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $363.08 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $363.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $309.03 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,380.38 |
Where New York sits
The same service costs 7.8 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· 41st of 51
$1,479
AK $5,888TX $759
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.