How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,715Professionalmedian $631 · 10th to 90th $513 to $1,096
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 $11,481.54 | Facility | None | $1,819.70 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | None | $691.83 | $691.83 | $794.33 |
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 $512.86 Median $602.56 Typical High $891.25 | Professional | None | $512.86 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $1,348.96 | Professional | 50 · Both sides | $776.25 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $380.19 Typical High $562.34 | Professional | 62 · Two surgeons | $323.59 | $380.19 | $562.34 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,348.96 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,513.56 | Professional | None | $660.69 | $660.69 | $1,513.56 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $2,754.23 | Facility | None | $758.58 | $954.99 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,202.26 | Professional | None | $616.60 | $776.25 | $1,202.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $912.01 | Professional | None | $398.11 | $616.60 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $724.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $724.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,698.24 | Professional | None | $691.83 | $724.44 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,621.81 | Professional | None | $467.74 | $691.83 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $616.60 Typical High $2,754.23 | Facility | None | $467.74 | $616.60 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $912.01 | Professional | None | $467.74 | $616.60 | $912.01 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $309.03 | $489.78 | $724.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $131.83 Typical High $190.55 | Professional | 55 · Aftercare only | $83.18 | $131.83 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $91.20 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $91.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $630.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $524.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $524.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $309.03 | $489.78 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $131.83 Typical High $380.19 | Professional | 55 · Aftercare only | $83.18 | $131.83 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $181.97 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $630.96 |
Where New York sits
The same service costs 4.8 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $10,454MT $2,169
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.