How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,096 to $7,413Professionalmedian $1,175 · 10th to 90th $912 to $2,089
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 $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,230.27 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,548.82 | Professional | None | $977.24 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,737.80 Typical High $2,290.87 | Professional | 50 · Both sides | $1,445.44 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $954.99 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $239.88 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $213.80 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $213.80 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $3,235.94 | Facility | None | $1,174.90 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,174.90 | $2,691.53 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $4,786.30 | Facility | None | $1,023.29 | $1,513.56 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,445.44 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,445.44 | Professional | None | $794.33 | $1,122.02 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $954.99 Median $4,786.30 Typical High $5,754.40 | Facility | None | $954.99 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,348.96 | $3,162.28 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,412.54 Typical High $3,162.28 | Professional | None | $794.33 | $1,412.54 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $4,168.69 | Facility | None | $1,071.52 | $1,148.15 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,380.38 | Professional | None | $794.33 | $1,122.02 | $1,380.38 |
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 $616.60 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $977.24 Typical High $1,318.26 | Professional | 54 · Surgery only | $691.83 | $977.24 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $144.54 Typical High $199.53 | Professional | 55 · Aftercare only | $104.71 | $144.54 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | 56 · Pre-op care only | $87.10 | $123.03 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $851.14 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $602.56 | $851.14 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $645.65 Typical High $1,023.29 | Professional | 53 · Discontinued | $616.60 | $645.65 | $1,023.29 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $794.33 | $977.24 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $398.11 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $398.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $123.03 Typical High $338.84 | Professional | 56 · Pre-op care only | $100.00 | $123.03 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $851.14 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $691.83 | $851.14 | $1,148.15 |
Where New York sits
The same service costs 5.8 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
$1,175
AK $4,898TX $851
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.