How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $9,333Professionalmedian $813 · 10th to 90th $562 to $1,413
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 $588.84 Median $707.95 Typical High $891.25 | Professional | None | $588.84 | $707.95 | $891.25 |
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 $676.08 Median $812.83 Typical High $1,445.44 | Professional | None | $676.08 | $812.83 | $1,445.44 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,348.96 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $891.25 Typical High $1,479.11 | Professional | None | $457.09 | $891.25 | $1,479.11 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $2,570.40 | Facility | None | $524.81 | $812.83 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,122.02 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,023.29 | Professional | None | $588.84 | $794.33 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $691.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,479.11 | Professional | None | $851.14 | $851.14 | $1,479.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,606.93 | Facility | None | $831.76 | $2,290.87 | $6,606.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,412.54 | Professional | None | $467.74 | $776.25 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $2,454.71 | Facility | None | $524.81 | $794.33 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,023.29 | Professional | None | $588.84 | $794.33 | $1,023.29 |
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 $295.12 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $117.49 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $549.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $478.63 | $676.08 | $812.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $112.20 | $158.49 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $58.88 | $83.18 | $102.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $724.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $562.34 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $562.34 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $478.63 | $724.44 | $812.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $169.82 Typical High $218.78 | Professional | 55 · Aftercare only | $112.20 | $169.82 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $89.13 Typical High $114.82 | Professional | 56 · Pre-op care only | $58.88 | $89.13 | $114.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $630.96 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $416.87 | $630.96 | $794.33 |
Where New York sits
The same service costs 4.9 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· 37th of 51
$832
AK $2,884TX $589
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.