How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $11,220Professionalmedian $550 · 10th to 90th $437 to $813
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | None | $512.86 | $616.60 | $616.60 |
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 $457.09 Median $549.54 Typical High $676.08 | Professional | None | $457.09 | $549.54 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $338.84 Typical High $467.74 | Professional | 62 · Two surgeons | $288.40 | $338.84 | $467.74 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,445.44 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,122.02 | Professional | None | $446.68 | $446.68 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $1,862.09 | Facility | None | $524.81 | $707.95 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $831.76 | Professional | None | $436.52 | $537.03 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $660.69 | Professional | None | $281.84 | $436.52 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $562.34 Median $3,235.94 Typical High $4,365.16 | Facility | None | $562.34 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,288.25 | Professional | None | $524.81 | $691.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $1,148.15 | Professional | None | $316.23 | $489.78 | $1,148.15 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $2,454.71 | Facility | None | $331.13 | $436.52 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $660.69 | Professional | None | $331.13 | $436.52 | $660.69 |
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 $257.04 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $426.58 | $426.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $338.84 Typical High $562.34 | Professional | 54 · Surgery only | $223.87 | $338.84 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $91.20 Typical High $147.91 | Professional | 55 · Aftercare only | $60.26 | $91.20 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $70.79 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $302.00 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $194.98 | $302.00 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $398.11 | Professional | 53 · Discontinued | $263.03 | $275.42 | $398.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $338.84 Typical High $524.81 | Professional | 54 · Surgery only | $223.87 | $338.84 | $524.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $91.20 Typical High $263.03 | Professional | 55 · Aftercare only | $60.26 | $91.20 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $302.00 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $194.98 | $302.00 | $457.09 |
Where New York sits
The same service costs 18.2 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· 40th of 51
$550
AK $1,995TX $110
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.