How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $9,772Professionalmedian $741 · 10th to 90th $525 to $1,318
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 $1,621.81 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,621.81 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $812.83 | Professional | None | $575.44 | $616.60 | $812.83 |
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 $630.96 Median $758.58 Typical High $1,318.26 | Professional | None | $630.96 | $758.58 | $1,318.26 |
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 $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,023.29 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,235.94 Typical High $6,309.57 | Facility | None | $1,348.96 | $3,235.94 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $1,348.96 | Professional | None | $467.74 | $891.25 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $2,570.40 | Facility | None | $524.81 | $794.33 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,737.80 | Professional | None | $912.01 | $1,000.00 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $933.25 | Professional | None | $537.03 | $691.83 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $4,786.30 Typical High $5,754.40 | Facility | None | $707.95 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,122.02 | Professional | None | $549.54 | $549.54 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,348.96 | Professional | None | $457.09 | $758.58 | $1,348.96 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $2,089.30 | Facility | None | $537.03 | $724.44 | $2,089.30 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $933.25 | Professional | None | $537.03 | $724.44 | $933.25 |
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 $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $524.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $616.60 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $177.83 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $75.86 Typical High $93.33 | Professional | 56 · Pre-op care only | $53.70 | $75.86 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $380.19 | $537.03 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $436.52 | $660.69 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $154.88 Typical High $199.53 | Professional | 55 · Aftercare only | $102.33 | $154.88 | $199.53 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $53.70 | $81.28 | $104.71 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $575.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $380.19 | $575.44 | $724.44 |
Where New York sits
The same service costs 4.5 times more in Alaska than in South Carolina. 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 $7,738SC $1,719
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.