How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,230 to $9,772Professionalmedian $537 · 10th to 90th $427 to $1,175
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,949.84 | Professional | None | $645.65 | $645.65 | $1,949.84 |
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 $426.58 Median $512.86 Typical High $1,071.52 | Professional | None | $426.58 | $512.86 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $758.58 Typical High $1,621.81 | Professional | 50 · Both sides | $630.96 | $758.58 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $316.23 Typical High $676.08 | Professional | 62 · Two surgeons | $269.15 | $316.23 | $676.08 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,318.26 | $2,754.23 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,949.84 | Professional | None | $489.78 | $562.34 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,511.89 | Facility | None | $645.65 | $1,202.26 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,122.02 | Professional | None | $602.56 | $691.83 | $1,122.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $794.33 | Professional | None | $380.19 | $501.19 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $691.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,513.56 | Professional | None | $912.01 | $912.01 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,737.80 | Professional | None | $457.09 | $676.08 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $2,511.89 | Facility | None | $407.38 | $537.03 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $794.33 | Professional | None | $380.19 | $501.19 | $794.33 |
14 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 $323.59 Median $323.59 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $537.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $467.74 Typical High $758.58 | Professional | 54 · Surgery only | $354.81 | $467.74 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $57.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $74.13 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $426.58 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $323.59 | $426.58 | $691.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $478.63 Typical High $758.58 | Professional | 54 · Surgery only | $354.81 | $478.63 | $758.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $77.62 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $77.62 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $46.77 Typical High $100.00 | Professional | 56 · Pre-op care only | $34.67 | $46.77 | $100.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $436.52 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $323.59 | $436.52 | $691.83 |
Where New York sits
The same service costs 5.9 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· 50th of 51
$562
AK $3,236TX $550
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.