How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,000 to $9,772Professionalmedian $417 · 10th to 90th $269 to $676
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 $588.84 Median $5,495.41 Typical High $10,715.19 | Facility | None | $588.84 | $5,495.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $478.63 | Professional | None | $316.23 | $436.52 | $478.63 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 50 · Both sides | $489.78 | $489.78 | $489.78 |
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 $371.54 Median $436.52 Typical High $602.56 | Professional | None | $371.54 | $436.52 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $630.96 Typical High $724.44 | Professional | 50 · Both sides | $524.81 | $630.96 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $275.42 Typical High $338.84 | Professional | 62 · Two surgeons | $234.42 | $275.42 | $338.84 |
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 $398.11 Median $398.11 Typical High $602.56 | Professional | None | $398.11 | $398.11 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,348.96 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $891.25 | Professional | None | $251.19 | $389.05 | $891.25 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $1,174.90 | Facility | None | $302.00 | $602.56 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $741.31 | Professional | None | $371.54 | $489.78 | $741.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $549.54 | Professional | None | $234.42 | $398.11 | $549.54 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | 50 · Both sides | $5,754.40 | $5,754.40 | $5,754.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $323.59 Median $3,235.94 Typical High $4,365.16 | Facility | None | $323.59 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $1,047.13 | Professional | None | $446.68 | $478.63 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $758.58 | Professional | None | $229.09 | $363.08 | $758.58 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $1,288.25 | Facility | None | $190.55 | $371.54 | $1,288.25 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $549.54 | Professional | None | $275.42 | $371.54 | $549.54 |
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 $158.49 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $309.03 | $338.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $309.03 Typical High $457.09 | Professional | 54 · Surgery only | $186.21 | $309.03 | $457.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $83.18 Typical High $123.03 | Professional | 55 · Aftercare only | $48.98 | $83.18 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $39.81 Typical High $58.88 | Professional | 56 · Pre-op care only | $23.44 | $39.81 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $269.15 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $162.18 | $269.15 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $229.09 | $323.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $309.03 Typical High $426.58 | Professional | 54 · Surgery only | $186.21 | $309.03 | $426.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $83.18 Typical High $204.17 | Professional | 55 · Aftercare only | $48.98 | $83.18 | $204.17 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $39.81 Typical High $97.72 | Professional | 56 · Pre-op care only | $23.44 | $39.81 | $97.72 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $269.15 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $162.18 | $269.15 | $380.19 |
Where New York sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 34th of 51
$427
AK $1,413UT $240
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.