How much rates vary
Facilitymedian $3,090 · 10th to 90th $617 to $7,244Professionalmedian $251 · 10th to 90th $170 to $417
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 $1,096.48 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,096.48 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $288.40 | Professional | None | $181.97 | $269.15 | $288.40 |
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 $213.80 Median $251.19 Typical High $354.81 | Professional | None | $213.80 | $251.19 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $371.54 Typical High $524.81 | Professional | 50 · Both sides | $316.23 | $371.54 | $524.81 |
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 $245.47 Median $245.47 Typical High $389.05 | Professional | None | $245.47 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $2,570.40 | Facility | None | $870.96 | $1,288.25 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $588.84 | Professional | None | $165.96 | $263.03 | $588.84 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $186.21 Typical High $616.60 | Facility | None | $89.13 | $186.21 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $501.19 | Professional | None | $251.19 | $331.13 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $354.81 | Professional | None | $154.88 | $263.03 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $3,235.94 Typical High $4,365.16 | Facility | None | $181.97 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $588.84 | Professional | None | $169.82 | $169.82 | $588.84 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $4,897.79 | Facility | None | $537.03 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $489.78 | Professional | None | $144.54 | $234.42 | $489.78 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $251.19 Typical High $691.83 | Facility | None | $117.49 | $251.19 | $691.83 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $354.81 | Professional | None | $181.97 | $251.19 | $354.81 |
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 $91.20 Median $134.90 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $53.70 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $208.93 | Professional | 54 · Surgery only | $138.04 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $40.74 Typical High $41.69 | Professional | 55 · Aftercare only | $27.54 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $190.55 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $128.82 | $190.55 | $194.98 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $234.42 Typical High $316.23 | Professional | 54 · Surgery only | $138.04 | $234.42 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $26.30 Typical High $35.48 | Professional | 55 · Aftercare only | $15.49 | $26.30 | $35.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.49 | $26.30 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $123.03 | $208.93 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $208.93 | Professional | 53 · Discontinued | $141.25 | $147.91 | $208.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $234.42 Typical High $316.23 | Professional | 54 · Surgery only | $138.04 | $234.42 | $316.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $26.30 Typical High $60.26 | Professional | 55 · Aftercare only | $15.49 | $26.30 | $60.26 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.30 Typical High $60.26 | Professional | 56 · Pre-op care only | $15.49 | $26.30 | $60.26 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $123.03 | $208.93 | $281.84 |
Where New York sits
The same service costs 4.1 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· 39th of 51
$251
AK $851TX $209
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.