How much rates vary
Facilitymedian $3,020 · 10th to 90th $617 to $7,079Professionalmedian $676 · 10th to 90th $525 to $1,122
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 $1,548.82 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,548.82 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
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 $562.34 Median $660.69 Typical High $933.25 | Professional | None | $562.34 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,380.38 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $3,019.95 | Facility | None | $1,000.00 | $1,513.56 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,584.89 | Professional | None | $676.08 | $676.08 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $2,570.40 | Facility | None | $588.84 | $812.83 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,288.25 | Professional | None | $776.25 | $776.25 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $912.01 | Professional | None | $398.11 | $616.60 | $912.01 |
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 $707.95 Median $1,000.00 Typical High $1,737.80 | Professional | None | $707.95 | $1,000.00 | $1,737.80 |
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 $467.74 Median $707.95 Typical High $1,698.24 | Professional | None | $467.74 | $707.95 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $524.81 Typical High $3,235.94 | Facility | None | $467.74 | $524.81 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $912.01 | Professional | None | $467.74 | $588.84 | $912.01 |
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 $346.74 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $316.23 | $489.78 | $724.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $128.82 Typical High $190.55 | Professional | 55 · Aftercare only | $83.18 | $128.82 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $91.20 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $91.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $630.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $537.03 | Professional | 53 · Discontinued | $354.81 | $363.08 | $537.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $316.23 | $489.78 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $128.82 Typical High $380.19 | Professional | 55 · Aftercare only | $83.18 | $128.82 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $181.97 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $630.96 |
Where New York sits
The same service costs 8.5 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· 44th of 51
$676
AK $2,818TX $331
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.