How much rates vary
Facilitymedian $2,630 · 10th to 90th $468 to $5,012Professionalmedian $490 · 10th to 90th $398 to $891
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 $3,890.45 Typical High $8,128.31 | Facility | None | $691.83 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $537.03 | Professional | None | $478.63 | $512.86 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $676.08 | Professional | None | $398.11 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $707.95 Typical High $1,023.29 | Professional | 50 · Both sides | $602.56 | $707.95 | $1,023.29 |
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 $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $1,479.11 | Facility | None | $186.21 | $380.19 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $1,122.02 | Professional | None | $467.74 | $512.86 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $630.96 Typical High $2,041.74 | Facility | None | $223.87 | $630.96 | $2,041.74 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | None | $478.63 | $741.31 | $1,122.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $691.83 | Professional | None | $295.12 | $512.86 | $691.83 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $457.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,318.26 | Professional | None | $371.54 | $371.54 | $1,318.26 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $1,174.90 | Professional | None | $380.19 | $537.03 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $478.63 Typical High $1,862.09 | Facility | None | $323.59 | $478.63 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $691.83 | Professional | None | $346.74 | $501.19 | $691.83 |
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 $239.88 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $380.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $407.38 Typical High $588.84 | Professional | 54 · Surgery only | $234.42 | $407.38 | $588.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $107.15 Typical High $154.88 | Professional | 55 · Aftercare only | $63.10 | $107.15 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $29.51 | $51.29 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $204.17 | $354.81 | $512.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $407.38 | Professional | 53 · Discontinued | $269.15 | $275.42 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $234.42 | $446.68 | $549.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $117.49 Typical High $263.03 | Professional | 55 · Aftercare only | $63.10 | $117.49 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $56.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $29.51 | $56.23 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $389.05 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $204.17 | $389.05 | $478.63 |
Where New York sits
The same service costs 5.2 times more in Connecticut than in Delaware. 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.
Physician feeFacility fee
CT $3,468DE $666
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.