How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,175 to $9,333Professionalmedian $851 · 10th to 90th $617 to $1,514
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 $776.25 Median $776.25 Typical High $2,041.74 | Professional | None | $776.25 | $776.25 | $2,041.74 |
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 $707.95 Median $851.14 Typical High $1,479.11 | Professional | None | $707.95 | $851.14 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $2,187.76 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $2,187.76 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,412.54 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,096.48 Typical High $1,621.81 | Professional | None | $575.44 | $1,096.48 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $3,162.28 | Facility | None | $616.60 | $1,000.00 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,659.59 | Professional | None | $870.96 | $954.99 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,047.13 | Professional | None | $602.56 | $776.25 | $1,047.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $7,762.47 | Facility | None | $831.76 | $831.76 | $7,762.47 |
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 $954.99 Median $954.99 Typical High $1,584.89 | Professional | None | $954.99 | $954.99 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $1,513.56 | Professional | None | $512.86 | $831.76 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $660.69 Median $812.83 Typical High $2,884.03 | Facility | None | $660.69 | $812.83 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,047.13 | Professional | None | $602.56 | $776.25 | $1,047.13 |
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 $389.05 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $630.96 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $147.91 Typical High $199.53 | Professional | 55 · Aftercare only | $114.82 | $147.91 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $104.71 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $104.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $549.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $426.58 | $549.54 | $741.31 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $588.84 Typical High $691.83 | Professional | 53 · Discontinued | $467.74 | $588.84 | $691.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $630.96 | $851.14 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $147.91 Typical High $223.87 | Professional | 55 · Aftercare only | $114.82 | $147.91 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $117.49 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $117.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $549.54 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $426.58 | $549.54 | $812.83 |
Where New York sits
The same service costs 7.6 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· 46th of 51
$891
AK $3,631TX $479
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.