How much rates vary
Facilitymedian $3,548 · 10th to 90th $692 to $8,710Professionalmedian $302 · 10th to 90th $209 to $537
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 $5,754.40 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $323.59 | Professional | None | $223.87 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $416.87 | Professional | None | $263.03 | $309.03 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $467.74 Typical High $616.60 | Professional | 50 · Both sides | $398.11 | $467.74 | $616.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $194.98 Typical High $263.03 | Professional | 62 · Two surgeons | $165.96 | $194.98 | $263.03 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $446.68 | Professional | None | $309.03 | $309.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $467.74 Typical High $1,819.70 | Facility | None | $251.19 | $467.74 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $660.69 | Professional | None | $199.53 | $281.84 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $851.14 | Facility | None | $234.42 | $331.13 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $407.38 | Professional | None | $173.78 | $295.12 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $331.13 Median $851.14 Typical High $851.14 | Professional | None | $331.13 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,388.44 | $9,549.93 |
United Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $575.44 | Professional | None | $177.83 | $281.84 | $575.44 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $912.01 | Facility | None | $151.36 | $295.12 | $912.01 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $407.38 | Professional | None | $173.78 | $295.12 | $407.38 |
10 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 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $229.09 Typical High $323.59 | Professional | 54 · Surgery only | $138.04 | $229.09 | $323.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $61.66 Typical High $85.11 | Professional | 55 · Aftercare only | $37.15 | $61.66 | $85.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $17.38 | $29.51 | $40.74 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $199.53 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $120.23 | $199.53 | $281.84 |
Fidelis Setting Professional Modifier 58 · Staged procedure Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 58 · Staged procedure | $275.42 | $275.42 | $275.42 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $229.09 Typical High $323.59 | Professional | 54 · Surgery only | $138.04 | $229.09 | $323.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $61.66 Typical High $85.11 | Professional | 55 · Aftercare only | $37.15 | $61.66 | $85.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $17.38 | $29.51 | $40.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $199.53 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $120.23 | $199.53 | $281.84 |
Where New York sits
The same service costs 5.0 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· 35th of 51
$309
AK $912TX $182
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.