How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $9,772Professionalmedian $589 · 10th to 90th $468 to $1,000
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,174.90 | Professional | None | $588.84 | $588.84 | $1,174.90 |
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 $478.63 Median $562.34 Typical High $794.33 | Professional | None | $478.63 | $562.34 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $851.14 Typical High $1,174.90 | Professional | 50 · Both sides | $724.44 | $851.14 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $354.81 Typical High $489.78 | Professional | 62 · Two surgeons | $302.00 | $354.81 | $489.78 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,148.15 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,348.96 | Professional | None | $588.84 | $588.84 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $2,187.76 | Facility | None | $407.38 | $676.08 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,023.29 | Professional | None | $549.54 | $676.08 | $1,023.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $776.25 | Professional | None | $338.84 | $537.03 | $776.25 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $4,365.16 | Facility | None | $616.60 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $1,479.11 | Professional | None | $616.60 | $645.65 | $1,479.11 |
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 $407.38 Median $602.56 Typical High $1,445.44 | Professional | None | $407.38 | $602.56 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $2,398.83 | Facility | None | $398.11 | $549.54 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $776.25 | Professional | None | $398.11 | $537.03 | $776.25 |
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 $295.12 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $426.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $416.87 Typical High $616.60 | Professional | 54 · Surgery only | $269.15 | $416.87 | $616.60 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $112.20 Typical High $165.96 | Professional | 55 · Aftercare only | $70.79 | $112.20 | $165.96 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $77.62 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $77.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $537.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | 53 · Discontinued | $309.03 | $309.03 | $457.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $416.87 Typical High $616.60 | Professional | 54 · Surgery only | $269.15 | $416.87 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $112.20 Typical High $323.59 | Professional | 55 · Aftercare only | $70.79 | $112.20 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $154.88 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $154.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $549.54 |
Where New York sits
The same service costs 7.9 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· 46th of 51
$589
AK $2,455TX $309
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.