How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,413 to $11,749Professionalmedian $1,259 · 10th to 90th $977 to $1,778
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,584.89 | $1,778.28 |
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 $1,047.13 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,230.27 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,819.70 Typical High $2,630.27 | Professional | 50 · Both sides | $1,548.82 | $1,819.70 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $776.25 Typical High $1,096.48 | Professional | 62 · Two surgeons | $645.65 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $281.84 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $245.47 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $4,365.16 | Facility | None | $1,202.26 | $1,412.54 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,318.26 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,737.80 | Professional | None | $851.14 | $1,096.48 | $1,737.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
MVP Health Care Setting Facility Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,548.82 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,380.38 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $11,748.98 | Facility | None | $1,318.26 | $3,890.45 | $11,748.98 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $2,041.74 | Professional | None | $870.96 | $1,318.26 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,981.07 | Facility | None | $1,148.15 | $1,258.93 | $3,981.07 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,737.80 | Professional | None | $851.14 | $1,096.48 | $1,737.80 |
14 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 $794.33 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $741.31 | $870.96 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $346.74 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $109.65 Typical High $173.78 | Professional | 56 · Pre-op care only | $91.20 | $109.65 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $1,380.38 | Professional | 54 · Surgery only | $741.31 | $912.01 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $229.09 Typical High $512.86 | Professional | 55 · Aftercare only | $186.21 | $229.09 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $114.82 Typical High $257.04 | Professional | 56 · Pre-op care only | $91.20 | $114.82 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $794.33 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $645.65 | $794.33 | $1,230.27 |
Where New York sits
The same service costs 8.3 times more in Wyoming 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· 45th of 51
$1,288
WY $5,623UT $676
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.