How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $11,482Professionalmedian $1,660 · 10th to 90th $1,288 to $3,548
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 $6,309.57 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,309.57 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $4,073.80 | Professional | None | $1,659.59 | $1,659.59 | $4,073.80 |
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 $1,412.54 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,659.59 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,511.89 Typical High $4,786.30 | Professional | 50 · Both sides | $2,137.96 | $2,511.89 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $512.86 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $446.68 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $446.68 |
CDPHP Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $7,762.47 | Facility | None | $851.14 | $1,778.28 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $6,606.93 | Professional | None | $1,318.26 | $1,905.46 | $6,606.93 |
Emblem Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,388.44 Typical High $6,309.57 | Facility | None | $1,778.28 | $3,388.44 | $6,309.57 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,778.28 | $1,949.84 | $3,090.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,445.44 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $4,365.16 | Professional | None | $2,344.23 | $2,344.23 | $4,365.16 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,737.80 Typical High $4,897.79 | Professional | None | $977.24 | $1,737.80 | $4,897.79 |
Univera Setting Facility Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $5,623.41 | Facility | None | $1,288.25 | $1,348.96 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,445.44 | $2,041.74 |
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 $831.76 Median $831.76 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | 53 · Discontinued | $331.13 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $309.03 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $309.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $102.33 Typical High $151.36 | Professional | 56 · Pre-op care only | $81.28 | $102.33 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,148.15 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $933.25 | $1,148.15 | $1,737.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $1,174.90 Typical High $1,778.28 | Professional | 53 · Discontinued | $891.25 | $1,174.90 | $1,778.28 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $478.63 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $478.63 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $102.33 Typical High $239.88 | Professional | 56 · Pre-op care only | $81.28 | $102.33 | $239.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,621.81 |
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
$1,698
AK $7,079TX $324
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.