How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,047 to $8,318Professionalmedian $617 · 10th to 90th $479 to $1,023
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 $10,964.78 | Facility | None | $1,819.70 | $5,754.40 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | None | $630.96 | $630.96 | $707.95 |
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 $512.86 Median $602.56 Typical High $831.76 | Professional | None | $512.86 | $602.56 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Professional | 50 · Both sides | $758.58 | $891.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $380.19 Typical High $524.81 | Professional | 62 · Two surgeons | $323.59 | $380.19 | $524.81 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $3,019.95 | Facility | None | $1,071.52 | $1,905.46 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,380.38 | Professional | None | $616.60 | $616.60 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $2,454.71 | Facility | None | $645.65 | $812.83 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,071.52 | Professional | None | $575.44 | $707.95 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $831.76 | Professional | None | $354.81 | $562.34 | $831.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
MVP Health Care Setting Facility Modifier None Typical Low $575.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $575.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,584.89 | Professional | None | $645.65 | $776.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,202.26 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,445.44 | Professional | None | $426.58 | $645.65 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $2,290.87 | Facility | None | $416.87 | $575.44 | $2,290.87 |
Univera Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $831.76 | Professional | None | $416.87 | $562.34 | $831.76 |
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 $316.23 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $707.95 | Professional | 54 · Surgery only | $281.84 | $446.68 | $707.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $186.21 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $56.23 Typical High $89.13 | Professional | 56 · Pre-op care only | $35.48 | $56.23 | $89.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $616.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $489.78 | Professional | 53 · Discontinued | $323.59 | $331.13 | $489.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $446.68 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $331.13 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $56.23 Typical High $158.49 | Professional | 56 · Pre-op care only | $35.48 | $56.23 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $575.44 |
Where New York sits
The same service costs 7.2 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· 45th of 51
$617
AK $2,570UT $355
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.