How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,148 to $9,333Professionalmedian $813 · 10th to 90th $646 to $1,413
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Professional | None | $870.96 | $870.96 | $891.25 |
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 $676.08 Median $794.33 Typical High $1,148.15 | Professional | None | $676.08 | $794.33 | $1,148.15 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,445.44 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,949.84 | Professional | None | $851.14 | $851.14 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $3,388.44 | Facility | None | $891.25 | $1,071.52 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,621.81 | Professional | None | $977.24 | $977.24 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,148.15 | Professional | None | $489.78 | $776.25 | $1,148.15 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,187.76 | Professional | None | $812.83 | $812.83 | $2,187.76 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,760.83 | Facility | None | $831.76 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $2,089.30 | Professional | None | $562.34 | $891.25 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $645.65 Typical High $2,951.21 | Facility | None | $575.44 | $645.65 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,148.15 | Professional | None | $575.44 | $724.44 | $1,148.15 |
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 $436.52 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $389.05 | $616.60 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $239.88 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $114.82 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $338.84 | $537.03 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $457.09 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $389.05 | $616.60 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $467.74 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $223.87 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $338.84 | $537.03 | $794.33 |
Where New York sits
The same service costs 7.1 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· 45th of 51
$832
AK $3,548TX $501
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.