How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $7,413Professionalmedian $661 · 10th to 90th $479 to $1,202
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 $1,380.38 Median $4,786.30 Typical High $8,317.64 | Facility | None | $1,380.38 | $4,786.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $724.44 | Professional | None | $562.34 | $616.60 | $724.44 |
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 $549.54 Median $660.69 Typical High $1,202.26 | Professional | None | $549.54 | $660.69 | $1,202.26 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,000.00 | Professional | None | $891.25 | $891.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,230.27 | $1,905.46 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $1,202.26 | Professional | None | $436.52 | $794.33 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $758.58 Typical High $2,454.71 | Facility | None | $489.78 | $758.58 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,584.89 | Professional | None | $831.76 | $912.01 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $812.83 | Professional | None | $467.74 | $616.60 | $812.83 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $4,786.30 Typical High $5,754.40 | Facility | None | $660.69 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $977.24 | Professional | None | $549.54 | $549.54 | $977.24 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,202.26 | Professional | None | $407.38 | $660.69 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $660.69 Typical High $1,949.84 | Facility | None | $467.74 | $660.69 | $1,949.84 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $812.83 | Professional | None | $467.74 | $660.69 | $812.83 |
9 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 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $380.19 | $549.54 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $89.13 | $128.82 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $46.77 | $67.61 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $331.13 | $478.63 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $380.19 | $588.84 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $89.13 | $138.04 | $173.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $91.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $512.86 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $331.13 | $512.86 | $645.65 |
Where New York sits
The same service costs 4.0 times more in Alaska than in Delaware. 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.
Physician feeFacility fee
AK $5,661DE $1,425
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.