How much rates vary
Facilitymedian $3,311 · 10th to 90th $724 to $7,762Professionalmedian $347 · 10th to 90th $288 to $537
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 $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
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 $295.12 Median $346.74 Typical High $501.19 | Professional | None | $295.12 | $346.74 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $524.81 Typical High $758.58 | Professional | 50 · Both sides | $446.68 | $524.81 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $186.21 Median $218.78 Typical High $316.23 | Professional | 62 · Two surgeons | $186.21 | $218.78 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $831.76 | Professional | None | $302.00 | $316.23 | $831.76 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $398.11 Typical High $1,258.93 | Facility | None | $251.19 | $398.11 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $588.84 | Professional | None | $331.13 | $380.19 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $489.78 | Professional | None | $194.98 | $309.03 | $489.78 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $346.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | None | $416.87 | $416.87 | $537.03 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $588.84 | Professional | None | $245.47 | $380.19 | $588.84 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $1,047.13 | Facility | None | $331.13 | $363.08 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $489.78 | Professional | None | $194.98 | $309.03 | $489.78 |
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 $223.87 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $363.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $245.47 Typical High $389.05 | Professional | 54 · Surgery only | $208.93 | $245.47 | $389.05 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $97.72 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $48.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $218.78 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $186.21 | $218.78 | $346.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $239.88 Typical High $331.13 | Professional | 53 · Discontinued | $190.55 | $239.88 | $331.13 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $389.05 | Professional | 54 · Surgery only | $208.93 | $263.03 | $389.05 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $158.49 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $158.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $79.43 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $79.43 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $186.21 | $229.09 | $346.74 |
Where New York sits
The same service costs 6.9 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· 44th of 51
$363
AK $1,514UT $219
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.