How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,122 to $7,762Professionalmedian $871 · 10th to 90th $708 to $1,349
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
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 $724.44 Median $851.14 Typical High $1,288.25 | Professional | None | $724.44 | $851.14 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,949.84 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $812.83 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $812.83 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,715.35 | Facility | None | $1,318.26 | $1,862.09 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $2,187.76 | Professional | None | $794.33 | $831.76 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,311.31 | Facility | None | $758.58 | $1,071.52 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,548.82 | Professional | None | $870.96 | $1,000.00 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,288.25 | Professional | None | $478.63 | $812.83 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $5,754.40 | Facility | None | $851.14 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,000.00 | $1,318.26 |
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 $660.69 Median $954.99 Typical High $1,479.11 | Professional | None | $660.69 | $954.99 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $3,467.37 | Facility | None | $870.96 | $933.25 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,288.25 | Professional | None | $478.63 | $812.83 | $1,288.25 |
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 $549.54 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $1,023.29 | Professional | 54 · Surgery only | $549.54 | $660.69 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $257.04 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $128.82 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $891.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $602.56 Typical High $870.96 | Professional | 53 · Discontinued | $478.63 | $602.56 | $870.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $1,023.29 | Professional | 54 · Surgery only | $549.54 | $676.08 | $1,023.29 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $380.19 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $891.25 |
Where New York sits
The same service costs 7.4 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· 46th of 51
$891
AK $3,981UT $537
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.