How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,047 to $11,482Professionalmedian $1,072 · 10th to 90th $851 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 $1,819.70 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 $1,258.93 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,445.44 | Professional | None | $891.25 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,137.96 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $891.25 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $229.09 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $199.53 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,023.29 Median $1,071.52 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,071.52 | $2,630.27 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,365.16 | Facility | None | $1,202.26 | $1,862.09 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,122.02 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,380.38 | Professional | None | $724.44 | $1,023.29 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,071.52 | $2,884.03 |
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 $724.44 Median $1,318.26 Typical High $2,884.03 | Professional | None | $724.44 | $1,318.26 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,047.13 Typical High $3,548.13 | Facility | None | $977.24 | $1,047.13 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,380.38 | Professional | None | $724.44 | $1,023.29 | $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 $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $891.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $630.96 | $891.25 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $131.83 Typical High $181.97 | Professional | 55 · Aftercare only | $95.50 | $131.83 | $181.97 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $112.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $81.28 | $112.20 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $776.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $549.54 | $776.25 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $588.84 Typical High $933.25 | Professional | 53 · Discontinued | $562.34 | $588.84 | $933.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $891.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $724.44 | $891.25 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $354.81 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $302.00 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $1,047.13 |
Where New York sits
The same service costs 21.9 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· 43rd of 51
$1,072
AK $4,467TX $204
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.