How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,288 to $14,125Professionalmedian $661 · 10th to 90th $525 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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,318.26 | Professional | None | $676.08 | $676.08 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $891.25 | Professional | None | $537.03 | $630.96 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $954.99 Typical High $1,318.26 | Professional | 50 · Both sides | $812.83 | $954.99 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $398.11 Typical High $562.34 | Professional | 62 · Two surgeons | $338.84 | $398.11 | $562.34 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
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 $1,445.44 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,445.44 | $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 $501.19 Median $776.25 Typical High $2,454.71 | Facility | None | $501.19 | $776.25 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,148.15 | Professional | None | $616.60 | $741.31 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $870.96 | Professional | None | $380.19 | $588.84 | $870.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Facility | None | $12,022.64 | $12,022.64 | $12,022.64 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $5,754.40 | Facility | None | $676.08 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,698.24 | Professional | None | $691.83 | $912.01 | $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 $446.68 Median $691.83 Typical High $1,621.81 | Professional | None | $446.68 | $691.83 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $3,162.28 | Facility | None | $446.68 | $616.60 | $3,162.28 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $870.96 | Professional | None | $446.68 | $588.84 | $870.96 |
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 $338.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
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 $67.61 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $69.18 |
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 $302.00 Median $467.74 Typical High $741.31 | Professional | 54 · Surgery only | $302.00 | $467.74 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $125.89 Typical High $199.53 | Professional | 55 · Aftercare only | $79.43 | $125.89 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $93.33 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $407.38 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $263.03 | $407.38 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $512.86 | Professional | 53 · Discontinued | $346.74 | $354.81 | $512.86 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $467.74 Typical High $691.83 | Professional | 54 · Surgery only | $302.00 | $467.74 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $125.89 Typical High $354.81 | Professional | 55 · Aftercare only | $79.43 | $125.89 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $169.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $407.38 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $263.03 | $407.38 | $616.60 |
Where New York sits
The same service costs 8.1 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
$661
AK $2,754TX $339
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.