How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,549 to $11,749Professionalmedian $1,479 · 10th to 90th $1,175 to $3,162
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 $1,905.46 Median $6,309.57 Typical High $12,882.50 | Facility | None | $1,905.46 | $6,309.57 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $4,365.16 | Professional | None | $1,659.59 | $1,659.59 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,445.44 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,819.70 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,819.70 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $10,232.93 | Facility | None | $2,511.89 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $6,165.95 | Professional | None | $1,230.27 | $1,698.24 | $6,165.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $5,754.40 | Facility | None | $1,584.89 | $1,819.70 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,819.70 | $3,019.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,380.38 | $2,137.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $10,232.93 | Facility | None | $9,549.93 | $9,549.93 | $10,232.93 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,621.81 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $4,073.80 | Professional | None | $1,698.24 | $1,698.24 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $4,570.88 | Professional | None | $1,174.90 | $1,659.59 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $5,248.07 | Facility | None | $1,148.15 | $1,479.11 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,380.38 | $1,819.70 |
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 $831.76 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $2,041.74 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $331.13 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $234.42 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $234.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $1,778.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,071.52 Typical High $1,621.81 | Professional | 53 · Discontinued | $812.83 | $1,071.52 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $1,659.59 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $436.52 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $436.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $309.03 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $1,479.11 |
Where New York sits
The same service costs 6.3 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· 47th of 51
$1,514
AK $6,457UT $1,023
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.