How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,349 to $10,715Professionalmedian $1,660 · 10th to 90th $1,230 to $2,754
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 $3,801.89 Typical High $12,302.69 | Facility | None | $1,621.81 | $3,801.89 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,737.80 | $1,949.84 |
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 $1,479.11 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,737.80 | $2,238.72 |
CDPHP Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $12,882.50 | Facility | None | $4,365.16 | $4,365.16 | $12,882.50 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,905.46 | $1,905.46 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,818.38 | Facility | None | $1,047.13 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,548.82 | $3,467.37 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $4,786.30 | Facility | None | $1,230.27 | $2,041.74 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,041.74 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,238.72 | Professional | None | $954.99 | $1,659.59 | $2,238.72 |
Highmark BCBS Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,630.27 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,584.89 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,258.93 Typical High $8,709.64 | Facility | None | $891.25 | $1,258.93 | $8,709.64 |
Univera Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,412.54 | $2,238.72 |
14 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 $812.83 Median $870.96 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $263.03 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,318.26 Typical High $1,862.09 | Professional | 54 · Surgery only | $758.58 | $1,318.26 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $346.74 Typical High $501.19 | Professional | 55 · Aftercare only | $199.53 | $346.74 | $501.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $165.96 Typical High $239.88 | Professional | 56 · Pre-op care only | $95.50 | $165.96 | $239.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,148.15 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $660.69 | $1,148.15 | $1,621.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $933.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $891.25 | $933.25 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,318.26 Typical High $1,737.80 | Professional | 54 · Surgery only | $758.58 | $1,318.26 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $346.74 Typical High $831.76 | Professional | 55 · Aftercare only | $199.53 | $346.74 | $831.76 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $165.96 Typical High $398.11 | Professional | 56 · Pre-op care only | $95.50 | $165.96 | $398.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,148.15 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $660.69 | $1,148.15 | $1,513.56 |
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· 37th of 51
$1,698
AK $5,248TX $1,023
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.