How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,318 to $10,965Professionalmedian $1,122 · 10th to 90th $912 to $2,042
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 $5,248.07 Typical High $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | None | $1,318.26 | $1,318.26 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,584.89 | Professional | None | $954.99 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,698.24 Typical High $2,344.23 | Professional | 50 · Both sides | $1,445.44 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $977.24 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $251.19 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $218.78 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $218.78 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
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 $1,148.15 Median $1,621.81 Typical High $3,235.94 | Facility | None | $1,148.15 | $1,621.81 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,047.13 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $4,168.69 | Facility | None | $1,047.13 | $1,380.38 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,258.93 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,412.54 | Professional | None | $851.14 | $1,000.00 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,230.27 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,230.27 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,548.82 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $3,235.94 | Professional | None | $724.44 | $1,380.38 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $4,073.80 | Facility | None | $1,047.13 | $1,071.52 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | None | $851.14 | $1,000.00 | $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 $660.69 Median $660.69 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $1,318.26 | Professional | 54 · Surgery only | $741.31 | $870.96 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $194.98 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $165.96 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $645.65 Typical High $1,000.00 | Professional | 53 · Discontinued | $616.60 | $645.65 | $1,000.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $741.31 | $870.96 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $398.11 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $398.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $331.13 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $331.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $1,071.52 |
Where New York sits
The same service costs 6.2 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· 44th of 51
$1,175
AK $4,786UT $776
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.