How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $7,413Professionalmedian $468 · 10th to 90th $380 to $794
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 $1,513.56 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | None | $489.78 | $489.78 | $524.81 |
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 $380.19 Median $446.68 Typical High $645.65 | Professional | None | $380.19 | $446.68 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $660.69 Typical High $977.24 | Professional | 50 · Both sides | $562.34 | $660.69 | $977.24 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $3,019.95 | Facility | None | $954.99 | $1,513.56 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,096.48 | Professional | None | $489.78 | $489.78 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $288.40 Median $575.44 Typical High $1,905.46 | Facility | None | $288.40 | $575.44 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $870.96 | Professional | None | $457.09 | $575.44 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $660.69 | Professional | None | $288.40 | $457.09 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $467.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $467.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,230.27 | Professional | None | $501.19 | $630.96 | $1,230.27 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $1,202.26 | Professional | None | $346.74 | $501.19 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $1,995.26 | Facility | None | $338.84 | $457.09 | $1,995.26 |
Univera Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $660.69 | Professional | None | $338.84 | $457.09 | $660.69 |
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 $245.47 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $363.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $223.87 | $363.08 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $95.50 Typical High $147.91 | Professional | 55 · Aftercare only | $60.26 | $95.50 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $45.71 Typical High $70.79 | Professional | 56 · Pre-op care only | $28.84 | $45.71 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $316.23 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $194.98 | $316.23 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $380.19 | Professional | 53 · Discontinued | $251.19 | $257.04 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $363.08 Typical High $524.81 | Professional | 54 · Surgery only | $223.87 | $363.08 | $524.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $95.50 Typical High $269.15 | Professional | 55 · Aftercare only | $60.26 | $95.50 | $269.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $45.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $28.84 | $45.71 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $316.23 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $194.98 | $316.23 | $457.09 |
Where New York sits
The same service costs 7.6 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· 46th of 51
$468
AK $2,042TX $269
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.