How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,230 to $10,233Professionalmedian $955 · 10th to 90th $724 to $1,698
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | None | $870.96 | $870.96 | $1,258.93 |
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 $794.33 Median $954.99 Typical High $1,659.59 | Professional | None | $794.33 | $954.99 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $588.84 Typical High $1,047.13 | Professional | 62 · Two surgeons | $501.19 | $588.84 | $1,047.13 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,513.56 | $3,235.94 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $1,819.70 | Professional | None | $660.69 | $1,230.27 | $1,819.70 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $3,548.13 | Facility | None | $776.25 | $1,122.02 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,096.48 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,174.90 | Professional | None | $676.08 | $870.96 | $1,174.90 |
MVP Health Care Setting Facility Modifier None Typical Low $954.99 Median $4,786.30 Typical High $5,754.40 | Facility | None | $954.99 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,202.26 | $1,778.28 |
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 $575.44 Median $933.25 Typical High $1,698.24 | Professional | None | $575.44 | $933.25 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $3,311.31 | Facility | None | $741.31 | $912.01 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,174.90 | Professional | None | $676.08 | $870.96 | $1,174.90 |
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 $436.52 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $724.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $707.95 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $707.95 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $117.49 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $616.60 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $489.78 | $616.60 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $660.69 Typical High $776.25 | Professional | 53 · Discontinued | $524.81 | $660.69 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $707.95 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $707.95 | $954.99 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $251.19 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $134.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $616.60 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $616.60 | $912.01 |
Where New York sits
The same service costs 8.3 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· 44th of 51
$1,000
AK $4,074TX $490
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.