How much rates vary
Facilitymedian $2,754 · 10th to 90th $389 to $5,370Professionalmedian $240 · 10th to 90th $186 to $457
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 $346.74 Median $4,570.88 Typical High $8,128.31 | Facility | None | $346.74 | $4,570.88 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $416.87 | Professional | None | $245.47 | $295.12 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $346.74 | Professional | None | $199.53 | $234.42 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $354.81 Typical High $512.86 | Professional | 50 · Both sides | $302.00 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | 62 · Two surgeons | $125.89 | $147.91 | $213.80 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | None | $288.40 | $288.40 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $363.08 Typical High $1,479.11 | Facility | None | $194.98 | $363.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $478.63 | Professional | None | $162.18 | $194.98 | $478.63 |
Emblem Health Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $707.95 | Facility | None | $194.98 | $323.59 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $446.68 | Professional | None | $281.84 | $302.00 | $446.68 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $323.59 | Professional | None | $199.53 | $234.42 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $501.19 | Facility | None | $128.82 | $169.82 | $501.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $302.00 | Professional | None | $190.55 | $251.19 | $302.00 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $3,235.94 Typical High $4,365.16 | Facility | None | $645.65 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $478.63 | Professional | None | $346.74 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $4,897.79 | Facility | None | $537.03 | $1,659.59 | $4,897.79 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $380.19 | Professional | None | $154.88 | $223.87 | $380.19 |
Univera Setting Facility Modifier None Typical Low $194.98 Median $302.00 Typical High $2,137.96 | Facility | None | $194.98 | $302.00 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $323.59 | Professional | None | $199.53 | $245.47 | $323.59 |
17 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 $123.03 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $213.80 | $288.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $23.44 | $32.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.44 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $23.44 | $32.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $257.04 |
Fidelis Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 79 · Unrelated procedure after surgery | $138.04 | $138.04 | $138.04 |
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | 79 · Unrelated procedure after surgery | $229.09 | $251.19 | $302.00 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $154.88 Typical High $245.47 | Professional | 53 · Discontinued | $123.03 | $154.88 | $245.47 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $302.00 | Professional | 54 · Surgery only | $177.83 | $213.80 | $302.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.44 Typical High $47.86 | Professional | 55 · Aftercare only | $19.95 | $23.44 | $47.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.44 Typical High $47.86 | Professional | 56 · Pre-op care only | $19.95 | $23.44 | $47.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $302.00 |
Where New York sits
The same service costs 4.0 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· 48th of 51
$245
AK $813UT $204
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.