How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,202 to $9,333Professionalmedian $891 · 10th to 90th $646 to $1,585
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 $812.83 Median $812.83 Typical High $2,137.96 | Professional | None | $812.83 | $812.83 | $2,137.96 |
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 $741.31 Median $891.25 Typical High $1,548.82 | Professional | None | $741.31 | $891.25 | $1,548.82 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,479.11 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $1,949.84 | Professional | None | $602.56 | $1,148.15 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $3,311.31 | Facility | None | $645.65 | $1,023.29 | $3,311.31 |
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 $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $870.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,621.81 | Professional | None | $954.99 | $954.99 | $1,621.81 |
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 $537.03 Median $870.96 Typical High $1,584.89 | Professional | None | $537.03 | $870.96 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $2,951.21 | Facility | None | $691.83 | $851.14 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
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 $407.38 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $660.69 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $645.65 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $81.28 Typical High $109.65 | Professional | 56 · Pre-op care only | $63.10 | $81.28 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $446.68 | $575.44 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $616.60 Typical High $724.44 | Professional | 53 · Discontinued | $489.78 | $616.60 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $645.65 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $234.42 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $81.28 Typical High $123.03 | Professional | 56 · Pre-op care only | $63.10 | $81.28 | $123.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $575.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $575.44 | $851.14 |
Where New York sits
The same service costs 7.1 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· 44th of 51
$933
AK $3,802TX $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.