How much rates vary
Facilitymedian $3,311 · 10th to 90th $933 to $8,128Professionalmedian $741 · 10th to 90th $589 to $1,288
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 $6,309.57 Typical High $13,182.57 | Facility | None | $1,819.70 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $831.76 | Professional | None | $660.69 | $812.83 | $831.76 |
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 $630.96 Median $741.31 Typical High $1,023.29 | Professional | None | $630.96 | $741.31 | $1,023.29 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,570.40 | Facility | None | $912.01 | $1,513.56 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,737.80 | Professional | None | $602.56 | $758.58 | $1,737.80 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $2,187.76 | Facility | None | $524.81 | $707.95 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,445.44 | Professional | None | $724.44 | $954.99 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,047.13 | Professional | None | $457.09 | $758.58 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $5,754.40 | Facility | None | $676.08 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,949.84 | Professional | None | $812.83 | $912.01 | $1,949.84 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,548.82 | Professional | None | $467.74 | $724.44 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $724.44 Typical High $2,630.27 | Facility | None | $426.58 | $724.44 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,047.13 | Professional | None | $537.03 | $724.44 | $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 $331.13 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $331.13 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $501.19 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $602.56 Typical High $891.25 | Professional | 54 · Surgery only | $363.08 | $602.56 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $158.49 Typical High $234.42 | Professional | 55 · Aftercare only | $95.50 | $158.49 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $75.86 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $75.86 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $316.23 | $524.81 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $416.87 Typical High $602.56 | Professional | 53 · Discontinued | $407.38 | $416.87 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $602.56 Typical High $831.76 | Professional | 54 · Surgery only | $363.08 | $602.56 | $831.76 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $158.49 Typical High $407.38 | Professional | 55 · Aftercare only | $95.50 | $158.49 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $75.86 Typical High $194.98 | Professional | 56 · Pre-op care only | $45.71 | $75.86 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $316.23 | $524.81 | $724.44 |
Where New York sits
The same service costs 5.6 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· 41st of 51
$741
AK $2,630TX $468
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.