How much rates vary
Facilitymedian $4,571 · 10th to 90th $955 to $10,715Professionalmedian $589 · 10th to 90th $380 to $1,072
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 $363.08 Median $616.60 Typical High $794.33 | Professional | None | $363.08 | $616.60 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $891.25 | Professional | None | $501.19 | $588.84 | $891.25 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,148.15 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,548.82 | Professional | None | $446.68 | $724.44 | $1,548.82 |
Emblem Health Setting Facility Modifier None Typical Low $194.98 Median $549.54 Typical High $1,819.70 | Facility | None | $194.98 | $549.54 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,380.38 | Professional | None | $691.83 | $912.01 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $691.83 Typical High $933.25 | Professional | None | $398.11 | $691.83 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $331.13 Median $3,235.94 Typical High $4,365.16 | Facility | None | $331.13 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $1,778.28 | Professional | None | $194.98 | $194.98 | $1,778.28 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,760.83 | Facility | None | $831.76 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $1,230.27 | Professional | None | $346.74 | $588.84 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $295.12 Median $691.83 Typical High $933.25 | Facility | None | $295.12 | $691.83 | $933.25 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $933.25 | Professional | None | $467.74 | $691.83 | $933.25 |
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 $181.97 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $181.97 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $72.44 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $275.42 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $54.95 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $36.31 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $257.04 | $436.52 | $489.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $549.54 Typical High $776.25 | Professional | 54 · Surgery only | $316.23 | $549.54 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $144.54 Typical High $208.93 | Professional | 55 · Aftercare only | $83.18 | $144.54 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $69.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $39.81 | $69.18 | $100.00 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $478.63 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $275.42 | $478.63 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $371.54 Typical High $537.03 | Professional | 53 · Discontinued | $363.08 | $371.54 | $537.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $575.44 Typical High $724.44 | Professional | 54 · Surgery only | $316.23 | $575.44 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $151.36 Typical High $331.13 | Professional | 55 · Aftercare only | $83.18 | $151.36 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $72.44 Typical High $158.49 | Professional | 56 · Pre-op care only | $39.81 | $72.44 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $501.19 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $275.42 | $501.19 | $691.83 |
Where New York sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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· 39th of 51
$589
AK $2,138KY $363
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.