How much rates vary
Facilitymedian $3,090 · 10th to 90th $562 to $7,413Professionalmedian $457 · 10th to 90th $302 to $891
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 $1,148.15 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,148.15 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $549.54 | Professional | None | $371.54 | $436.52 | $549.54 |
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 $398.11 Median $478.63 Typical High $912.01 | Professional | None | $398.11 | $478.63 | $912.01 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $724.44 Typical High $1,479.11 | Facility | None | $436.52 | $724.44 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $891.25 | Professional | None | $223.87 | $489.78 | $891.25 |
Emblem Health Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $1,318.26 | Facility | None | $346.74 | $416.87 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $954.99 | Professional | None | $512.86 | $562.34 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $588.84 | Professional | None | $331.13 | $457.09 | $588.84 |
MVP Health Care Setting Facility Modifier None Typical Low $426.58 Median $3,235.94 Typical High $4,365.16 | Facility | None | $426.58 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $758.58 | Professional | None | $302.00 | $302.00 | $758.58 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $5,248.07 | Facility | None | $549.54 | $1,862.09 | $5,248.07 |
United Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $831.76 | Professional | None | $239.88 | $407.38 | $831.76 |
Univera Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $1,071.52 | Facility | None | $275.42 | $436.52 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $588.84 | Professional | None | $331.13 | $457.09 | $588.84 |
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 $186.21 Median $218.78 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $407.38 | Professional | 54 · Surgery only | $281.84 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $380.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $371.54 Typical High $478.63 | Professional | 54 · Surgery only | $263.03 | $371.54 | $478.63 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $112.20 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $234.42 | $323.59 | $416.87 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $346.74 Typical High $398.11 | Professional | 53 · Discontinued | $281.84 | $346.74 | $398.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $371.54 Typical High $478.63 | Professional | 54 · Surgery only | $263.03 | $371.54 | $478.63 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $123.03 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $123.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $64.57 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $323.59 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $234.42 | $323.59 | $436.52 |
Where New York sits
The same service costs 5.1 times more in Alaska than in Texas. 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· 39th of 51
$479
AK $1,514TX $295
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.