How much rates vary
Facilitymedian $3,311 · 10th to 90th $661 to $7,586Professionalmedian $355 · 10th to 90th $275 to $741
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 $537.03 Median $4,466.84 Typical High $8,128.31 | Facility | None | $537.03 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $537.03 | Professional | None | $251.19 | $354.81 | $537.03 |
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 $288.40 Median $338.84 Typical High $676.08 | Professional | None | $288.40 | $338.84 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $213.80 Typical High $426.58 | Professional | 62 · Two surgeons | $181.97 | $213.80 | $426.58 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,348.96 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $1,148.15 | Professional | None | $275.42 | $389.05 | $1,148.15 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $616.60 Typical High $1,047.13 | Facility | None | $275.42 | $616.60 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $724.44 | Professional | None | $457.09 | $512.86 | $724.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $524.81 | Professional | None | $275.42 | $380.19 | $524.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $5,495.41 Typical High $19,054.61 | Facility | None | $4,786.30 | $5,495.41 | $19,054.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $691.83 | Professional | None | $549.54 | $549.54 | $691.83 |
MVP Health Care Setting Facility Modifier None Typical Low $446.68 Median $3,235.94 Typical High $4,365.16 | Facility | None | $446.68 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $933.25 | Professional | None | $331.13 | $331.13 | $933.25 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $5,248.07 | Facility | None | $549.54 | $1,862.09 | $5,248.07 |
United Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $870.96 | Professional | None | $251.19 | $436.52 | $870.96 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $1,288.25 | Facility | None | $213.80 | $346.74 | $1,288.25 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $524.81 | Professional | None | $275.42 | $380.19 | $524.81 |
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 $158.49 Median $177.83 Typical High $263.03 | Professional | 52 · Reduced service | $158.49 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $107.15 | Professional | 53 · Discontinued | $63.10 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $398.11 | Professional | 54 · Surgery only | $239.88 | $269.15 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $79.43 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $53.70 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $363.08 Typical High $660.69 | Professional | 54 · Surgery only | $213.80 | $363.08 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $40.74 | $67.61 | $83.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $34.67 | $58.88 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $251.19 Typical High $407.38 | Professional | 53 · Discontinued | $199.53 | $251.19 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $363.08 Typical High $660.69 | Professional | 54 · Surgery only | $213.80 | $363.08 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $67.61 Typical High $346.74 | Professional | 55 · Aftercare only | $40.74 | $67.61 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $58.88 Typical High $346.74 | Professional | 56 · Pre-op care only | $34.67 | $58.88 | $346.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $660.69 |
Where New York sits
The same service costs 3.9 times more in Alaska than in New York. 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· 51st of 51
$355
AK $1,380NY $355
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.