How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $9,772Professionalmedian $851 · 10th to 90th $708 to $1,479
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 $724.44 Median $724.44 Typical High $977.24 | Professional | None | $724.44 | $724.44 | $977.24 |
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 $724.44 Median $851.14 Typical High $1,174.90 | Professional | None | $724.44 | $851.14 | $1,174.90 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,548.82 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $2,041.74 | Professional | None | $912.01 | $912.01 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $1,096.48 Typical High $3,548.13 | Facility | None | $741.31 | $1,096.48 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,071.52 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,202.26 | Professional | None | $512.86 | $851.14 | $1,202.26 |
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 $933.25 Median $1,122.02 Typical High $2,290.87 | Professional | None | $933.25 | $1,122.02 | $2,290.87 |
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 $645.65 Median $933.25 Typical High $2,187.76 | Professional | None | $645.65 | $933.25 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $691.83 Typical High $3,548.13 | Facility | None | $616.60 | $691.83 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,202.26 | Professional | None | $616.60 | $758.58 | $1,202.26 |
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 $363.08 Median $363.08 Typical High $489.78 | Professional | 52 · Reduced service | $363.08 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | 54 · Surgery only | $549.54 | $549.54 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $691.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $676.08 Typical High $1,023.29 | Professional | 54 · Surgery only | $407.38 | $676.08 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $177.83 Typical High $269.15 | Professional | 55 · Aftercare only | $109.65 | $177.83 | $269.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $85.11 Typical High $128.82 | Professional | 56 · Pre-op care only | $51.29 | $85.11 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $588.84 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $354.81 | $588.84 | $891.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $691.83 | Professional | 53 · Discontinued | $467.74 | $478.63 | $691.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $676.08 Typical High $954.99 | Professional | 54 · Surgery only | $407.38 | $676.08 | $954.99 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $177.83 Typical High $489.78 | Professional | 55 · Aftercare only | $109.65 | $177.83 | $489.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $85.11 Typical High $229.09 | Professional | 56 · Pre-op care only | $51.29 | $85.11 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $588.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $354.81 | $588.84 | $831.76 |
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
$851
AK $3,802TX $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.