How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $10,233Professionalmedian $589 · 10th to 90th $490 to $912
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | None | $776.25 | $776.25 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $891.25 Typical High $1,288.25 | Professional | 50 · Both sides | $758.58 | $891.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $371.54 Typical High $537.03 | Professional | 62 · Two surgeons | $316.23 | $371.54 | $537.03 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,348.96 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $1,412.54 | Professional | None | $512.86 | $537.03 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $2,238.72 | Facility | None | $549.54 | $676.08 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,023.29 | Professional | None | $562.34 | $660.69 | $1,023.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $851.14 | Professional | None | $331.13 | $537.03 | $851.14 |
MVP Health Care Setting Facility Modifier None Typical Low $588.84 Median $4,786.30 Typical High $5,754.40 | Facility | None | $588.84 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,000.00 | Professional | None | $426.58 | $645.65 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $616.60 Typical High $3,311.31 | Facility | None | $562.34 | $616.60 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $851.14 | Professional | None | $331.13 | $537.03 | $851.14 |
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 $380.19 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $676.08 | Professional | 54 · Surgery only | $363.08 | $426.58 | $676.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $169.82 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $85.11 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $85.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $588.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $407.38 Typical High $562.34 | Professional | 53 · Discontinued | $323.59 | $407.38 | $562.34 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $363.08 | $446.68 | $676.08 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $251.19 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $316.23 | $389.05 | $588.84 |
Where New York sits
The same service costs 8.5 times more in Wyoming 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· 45th of 51
$631
WY $3,020UT $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.