How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,349 to $10,233Professionalmedian $1,148 · 10th to 90th $933 to $1,862
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 $1,445.44 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,445.44 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $933.25 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,659.59 Typical High $2,630.27 | Professional | 50 · Both sides | $1,412.54 | $1,659.59 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,122.02 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $281.84 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $245.47 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $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 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $3,715.35 Typical High $7,413.10 | Facility | None | $1,584.89 | $3,715.35 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,148.15 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $4,570.88 | Facility | None | $1,258.93 | $1,479.11 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,380.38 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,737.80 | Professional | None | $630.96 | $1,122.02 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,148.15 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,148.15 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,949.84 | Professional | None | $912.01 | $1,288.25 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $4,073.80 | Facility | None | $1,202.26 | $1,258.93 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,737.80 | Professional | None | $630.96 | $1,122.02 | $1,737.80 |
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 $724.44 Median $724.44 Typical High $933.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $371.54 | Professional | 53 · Discontinued | $288.40 | $288.40 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | 54 · Surgery only | $776.25 | $912.01 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $346.74 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $112.20 Typical High $173.78 | Professional | 56 · Pre-op care only | $95.50 | $112.20 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $812.83 Typical High $1,174.90 | Professional | 53 · Discontinued | $645.65 | $812.83 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | 54 · Surgery only | $776.25 | $912.01 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $562.34 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $562.34 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $281.84 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $1,202.26 |
Where New York sits
The same service costs 7.1 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· 47th of 51
$1,175
AK $5,370UT $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.