How much rates vary
Facilitymedian $3,311 · 10th to 90th $933 to $7,586Professionalmedian $398 · 10th to 90th $288 to $631
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 $1,071.52 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,071.52 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $549.54 | Professional | None | $346.74 | $446.68 | $549.54 |
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 $354.81 Median $416.87 Typical High $630.96 | Professional | None | $354.81 | $416.87 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $630.96 Typical High $954.99 | Professional | 50 · Both sides | $537.03 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $263.03 Typical High $398.11 | Professional | 62 · Two surgeons | $223.87 | $263.03 | $398.11 |
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 $407.38 Median $407.38 Typical High $660.69 | Professional | None | $407.38 | $407.38 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,318.26 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $741.31 | Professional | None | $234.42 | $371.54 | $741.31 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $1,023.29 | Facility | None | $199.53 | $302.00 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $851.14 | Professional | None | $524.81 | $562.34 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $575.44 | Professional | None | $331.13 | $389.05 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $630.96 | Professional | None | $295.12 | $295.12 | $630.96 |
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 $234.42 Median $380.19 Typical High $602.56 | Professional | None | $234.42 | $380.19 | $602.56 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $933.25 | Facility | None | $281.84 | $331.13 | $933.25 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $575.44 | Professional | None | $331.13 | $371.54 | $575.44 |
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 $173.78 Median $218.78 Typical High $275.42 | Professional | 52 · Reduced service | $173.78 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $69.18 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $416.87 | Professional | 54 · Surgery only | $263.03 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $34.67 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $309.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $245.47 | $309.03 | $389.05 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $288.40 | $346.74 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $117.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $57.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $295.12 Typical High $398.11 | Professional | 53 · Discontinued | $229.09 | $295.12 | $398.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $331.13 Typical High $467.74 | Professional | 54 · Surgery only | $288.40 | $331.13 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $190.55 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $95.50 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $95.50 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $407.38 |
Where New York sits
The same service costs 5.5 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· 40th of 51
$407
AK $1,585UT $288
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.