How much rates vary
Facilitymedian $2,692 · 10th to 90th $490 to $5,248Professionalmedian $479 · 10th to 90th $398 to $851
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 $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | None | $478.63 | $478.63 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $676.08 | Professional | None | $407.38 | $478.63 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $724.44 Typical High $1,023.29 | Professional | 50 · Both sides | $616.60 | $724.44 | $1,023.29 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $1,737.80 | Facility | None | $186.21 | $380.19 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,174.90 | Professional | None | $524.81 | $524.81 | $1,174.90 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $2,089.30 | Facility | None | $512.86 | $645.65 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $933.25 | Professional | None | $489.78 | $616.60 | $933.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $707.95 | Professional | None | $309.03 | $489.78 | $707.95 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $457.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,318.26 | Professional | None | $467.74 | $467.74 | $1,318.26 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $1,202.26 | Professional | None | $354.81 | $537.03 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $2,137.96 | Facility | None | $363.08 | $489.78 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $707.95 | Professional | None | $363.08 | $489.78 | $707.95 |
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 $239.88 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $389.05 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $389.05 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $151.36 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $70.79 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $407.38 | Professional | 53 · Discontinued | $275.42 | $275.42 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $389.05 | $562.34 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $295.12 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $295.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $141.25 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $489.78 |
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· 43rd of 51
$490
AK $2,188TX $275
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.