How much rates vary
Facilitymedian $2,951 · 10th to 90th $513 to $7,079Professionalmedian $407 · 10th to 90th $339 to $776
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 $691.83 Median $3,981.07 Typical High $8,128.31 | Facility | None | $691.83 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $812.83 | Professional | None | $398.11 | $426.58 | $812.83 |
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 $338.84 Median $398.11 Typical High $575.44 | Professional | None | $338.84 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | 50 · Both sides | $501.19 | $588.84 | $851.14 |
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 $562.34 Median $562.34 Typical High $616.60 | Professional | None | $562.34 | $562.34 | $616.60 |
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 $389.05 Median $426.58 Typical High $977.24 | Professional | None | $389.05 | $426.58 | $977.24 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $501.19 Typical High $1,621.81 | Facility | None | $416.87 | $501.19 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $870.96 | Professional | None | $407.38 | $575.44 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $588.84 | Professional | None | $251.19 | $436.52 | $588.84 |
MVP Health Care Setting Facility Modifier None Typical Low $371.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $371.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $1,096.48 | Professional | None | $380.19 | $380.19 | $1,096.48 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,479.11 Typical High $4,365.16 | Facility | None | $363.08 | $1,479.11 | $4,365.16 |
United Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $977.24 | Professional | None | $288.40 | $436.52 | $977.24 |
Univera Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $1,445.44 | Facility | None | $269.15 | $407.38 | $1,445.44 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $588.84 | Professional | None | $302.00 | $407.38 | $588.84 |
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 $199.53 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $323.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $199.53 | $346.74 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $53.70 | $93.33 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $43.65 Typical High $58.88 | Professional | 56 · Pre-op care only | $25.12 | $43.65 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $302.00 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $173.78 | $302.00 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $331.13 | Professional | 53 · Discontinued | $223.87 | $229.09 | $331.13 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $363.08 Typical High $467.74 | Professional | 54 · Surgery only | $199.53 | $363.08 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $95.50 Typical High $223.87 | Professional | 55 · Aftercare only | $53.70 | $95.50 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $45.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $25.12 | $45.71 | $107.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $316.23 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $173.78 | $316.23 | $407.38 |
Where New York sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$417
AK $1,738UT $324
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.