How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,288 to $14,125Professionalmedian $575 · 10th to 90th $468 to $1,000
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | None | $616.60 | $616.60 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $812.83 | Professional | None | $467.74 | $562.34 | $812.83 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,318.26 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,380.38 | Professional | None | $602.56 | $602.56 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $2,398.83 | Facility | None | $630.96 | $776.25 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,047.13 | Professional | None | $562.34 | $691.83 | $1,047.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $812.83 | Professional | None | $346.74 | $549.54 | $812.83 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $4,786.30 Typical High $5,754.40 | Facility | None | $616.60 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,548.82 | Professional | None | $630.96 | $851.14 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $1,479.11 | Professional | None | $416.87 | $630.96 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $2,630.27 | Facility | None | $407.38 | $562.34 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $812.83 | Professional | None | $407.38 | $549.54 | $812.83 |
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 $309.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $446.68 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $436.52 | $630.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $114.82 Typical High $169.82 | Professional | 55 · Aftercare only | $72.44 | $114.82 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $54.95 Typical High $81.28 | Professional | 56 · Pre-op care only | $34.67 | $54.95 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $380.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $239.88 | $380.19 | $549.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $467.74 | Professional | 53 · Discontinued | $316.23 | $323.59 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $436.52 | $630.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $114.82 Typical High $331.13 | Professional | 55 · Aftercare only | $72.44 | $114.82 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $54.95 Typical High $158.49 | Professional | 56 · Pre-op care only | $34.67 | $54.95 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $380.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $239.88 | $380.19 | $562.34 |
Where New York sits
The same service costs 8.1 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· 46th of 51
$589
AK $2,512TX $309
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.