How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,318 to $10,965Professionalmedian $759 · 10th to 90th $617 to $1,660
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 $954.99 Median $1,047.13 Typical High $2,238.72 | Professional | None | $954.99 | $1,047.13 | $2,238.72 |
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 $630.96 Median $741.31 Typical High $1,513.56 | Professional | None | $630.96 | $741.31 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $467.74 Typical High $933.25 | Professional | 62 · Two surgeons | $389.05 | $467.74 | $933.25 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,466.84 Typical High $8,912.51 | Facility | None | $1,348.96 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $3,311.31 | Professional | None | $724.44 | $912.01 | $3,311.31 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $3,090.30 | Facility | None | $891.25 | $1,412.54 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,513.56 | Professional | None | $758.58 | $933.25 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | None | $588.84 | $724.44 | $1,348.96 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $4,786.30 | Facility | None | $891.25 | $891.25 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,230.27 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,162.28 | $10,232.93 |
United Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $2,344.23 | Professional | None | $616.60 | $891.25 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $741.31 Typical High $3,235.94 | Facility | None | $691.83 | $741.31 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,318.26 | Professional | None | $588.84 | $724.44 | $1,318.26 |
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 $478.63 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $724.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $1,258.93 | Professional | 54 · Surgery only | $537.03 | $660.69 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $123.03 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $109.65 | Professional | 56 · Pre-op care only | $47.86 | $58.88 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | 53 · Discontinued | $436.52 | $562.34 | $851.14 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $1,202.26 | Professional | 54 · Surgery only | $537.03 | $660.69 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $147.91 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $147.91 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $131.83 | Professional | 56 · Pre-op care only | $47.86 | $58.88 | $131.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $1,096.48 |
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· 49th of 51
$794
AK $3,467TX $589
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.