How much rates vary
Facilitymedian $3,802 · 10th to 90th $589 to $9,550Professionalmedian $479 · 10th to 90th $324 to $933
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 $416.87 Median $3,715.35 Typical High $8,317.64 | Facility | None | $416.87 | $3,715.35 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,000.00 | Professional | None | $398.11 | $588.84 | $1,000.00 |
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 $398.11 Median $478.63 Typical High $851.14 | Professional | None | $398.11 | $478.63 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $707.95 Typical High $1,258.93 | Professional | 50 · Both sides | $588.84 | $707.95 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $302.00 Typical High $537.03 | Professional | 62 · Two surgeons | $251.19 | $302.00 | $537.03 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $616.60 | Professional | None | $380.19 | $380.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $1,862.09 | Facility | None | $309.03 | $575.44 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $1,202.26 | Professional | None | $223.87 | $363.08 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $1,047.13 | Facility | None | $295.12 | $512.86 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $912.01 | Professional | None | $457.09 | $524.81 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $602.56 | Professional | None | $275.42 | $389.05 | $602.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,370.32 Typical High $6,456.54 | Facility | None | $2,951.21 | $5,370.32 | $6,456.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,000.00 | Professional | None | $346.74 | $346.74 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $478.63 Median $3,235.94 Typical High $4,365.16 | Facility | None | $478.63 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,122.02 | Professional | None | $630.96 | $630.96 | $1,122.02 |
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 $239.88 Median $436.52 Typical High $1,023.29 | Professional | None | $239.88 | $436.52 | $1,023.29 |
Univera Setting Facility Modifier None Typical Low $186.21 Median $398.11 Typical High $1,548.82 | Facility | None | $186.21 | $398.11 | $1,548.82 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $588.84 | Professional | None | $275.42 | $389.05 | $588.84 |
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 $208.93 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $436.52 Typical High $446.68 | Professional | 54 · Surgery only | $309.03 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $41.69 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $416.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $245.47 | $354.81 | $537.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $60.26 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $60.26 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.90 Typical High $60.26 | Professional | 56 · Pre-op care only | $27.54 | $38.90 | $60.26 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $218.78 | $316.23 | $478.63 |
Fidelis Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 79 · Unrelated procedure after surgery | $194.98 | $194.98 | $194.98 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $354.81 Typical High $524.81 | Professional | 54 · Surgery only | $245.47 | $354.81 | $524.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $75.86 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $75.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.90 Typical High $75.86 | Professional | 56 · Pre-op care only | $27.54 | $38.90 | $75.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $218.78 | $316.23 | $478.63 |
Where New York sits
The same service costs 4.1 times more in Wisconsin 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· 42nd of 51
$501
WI $1,549TX $380
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.