How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,230 to $10,965Professionalmedian $832 · 10th to 90th $676 to $1,820
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 $1,071.52 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,122.02 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,659.59 | Professional | None | $691.83 | $812.83 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $2,454.71 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $1,023.29 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $1,023.29 |
CDPHP Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $3,630.78 | Professional | None | $794.33 | $1,047.13 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,202.26 Typical High $3,467.37 | Facility | None | $977.24 | $1,202.26 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,659.59 | Professional | None | $954.99 | $1,047.13 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,479.11 | Professional | None | $645.65 | $794.33 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,786.30 | Facility | None | $1,000.00 | $1,000.00 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,023.29 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,344.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $2,570.40 | Professional | None | $676.08 | $977.24 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $3,388.44 | Facility | None | $776.25 | $812.83 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,479.11 | Professional | None | $645.65 | $794.33 | $1,479.11 |
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 $524.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $794.33 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | 54 · Surgery only | $588.84 | $724.44 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $131.83 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $64.57 Typical High $117.49 | Professional | 56 · Pre-op care only | $52.48 | $64.57 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $660.69 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $537.03 | $660.69 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $616.60 Typical High $933.25 | Professional | 53 · Discontinued | $478.63 | $616.60 | $933.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | 54 · Surgery only | $588.84 | $724.44 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $162.18 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $162.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $64.57 Typical High $144.54 | Professional | 56 · Pre-op care only | $52.48 | $64.57 | $144.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $660.69 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $537.03 | $660.69 | $1,230.27 |
Where New York sits
The same service costs 5.6 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· 49th of 51
$871
AK $3,715UT $661
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.