How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,148 to $7,586Professionalmedian $912 · 10th to 90th $741 to $1,995
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,230.27 | $2,344.23 |
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 $758.58 Median $891.25 Typical High $1,819.70 | Professional | None | $758.58 | $891.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $1,148.15 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $1,148.15 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $3,467.37 | Facility | None | $1,230.27 | $1,778.28 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $3,981.07 | Professional | None | $870.96 | $1,122.02 | $3,981.07 |
Emblem Health Setting Facility Modifier None Typical Low $724.44 Median $1,148.15 Typical High $3,548.13 | Facility | None | $724.44 | $1,148.15 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,862.09 | Professional | None | $977.24 | $1,122.02 | $1,862.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,621.81 | Professional | None | $724.44 | $891.25 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $4,786.30 | Facility | None | $1,071.52 | $1,071.52 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,122.02 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,818.38 | Professional | None | $741.31 | $1,071.52 | $2,818.38 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $3,235.94 | Facility | None | $851.14 | $891.25 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,621.81 | Professional | None | $724.44 | $891.25 | $1,621.81 |
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 $575.44 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $1,513.56 | Professional | 54 · Surgery only | $645.65 | $794.33 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $147.91 | Professional | 55 · Aftercare only | $64.57 | $79.43 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $70.79 Typical High $131.83 | Professional | 56 · Pre-op care only | $57.54 | $70.79 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $1,380.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | 53 · Discontinued | $524.81 | $676.08 | $1,023.29 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $1,479.11 | Professional | 54 · Surgery only | $645.65 | $794.33 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $177.83 | Professional | 55 · Aftercare only | $64.57 | $79.43 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $70.79 Typical High $158.49 | Professional | 56 · Pre-op care only | $57.54 | $70.79 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $1,348.96 |
Where New York sits
The same service costs 5.9 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· 48th of 51
$955
AK $4,074UT $692
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.