How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,000Professionalmedian $537 · 10th to 90th $437 to $933
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 $5,248.07 Typical High $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | None | $575.44 | $575.44 | $602.56 |
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 $436.52 Median $524.81 Typical High $758.58 | Professional | None | $436.52 | $524.81 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $776.25 Typical High $1,122.02 | Professional | 50 · Both sides | $660.69 | $776.25 | $1,122.02 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,148.15 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,230.27 | Professional | None | $562.34 | $562.34 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $2,137.96 | Facility | None | $416.87 | $660.69 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $977.24 | Professional | None | $524.81 | $645.65 | $977.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $758.58 | Professional | None | $323.59 | $512.86 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $549.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $549.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,412.54 | Professional | None | $588.84 | $676.08 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,380.38 | Professional | None | $389.05 | $588.84 | $1,380.38 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $2,187.76 | Facility | None | $380.19 | $524.81 | $2,187.76 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $758.58 | Professional | None | $380.19 | $512.86 | $758.58 |
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 $288.40 Median $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $416.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $588.84 | Professional | 54 · Surgery only | $257.04 | $407.38 | $588.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $107.15 Typical High $158.49 | Professional | 55 · Aftercare only | $67.61 | $107.15 | $158.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $75.86 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $75.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $512.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $295.12 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $588.84 | Professional | 54 · Surgery only | $257.04 | $407.38 | $588.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $107.15 Typical High $309.03 | Professional | 55 · Aftercare only | $67.61 | $107.15 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $147.91 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $147.91 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $524.81 |
Where New York sits
The same service costs 7.9 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· 46th of 51
$550
AK $2,344TX $295
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.