How much rates vary
Facilitymedian $3,715 · 10th to 90th $724 to $8,913Professionalmedian $380 · 10th to 90th $316 to $661
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
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 $316.23 Median $371.54 Typical High $537.03 | Professional | None | $316.23 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $812.83 | Professional | 50 · Both sides | $467.74 | $549.54 | $812.83 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $5,370.32 | Facility | None | $954.99 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $912.01 | Professional | None | $407.38 | $407.38 | $912.01 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $478.63 Typical High $1,584.89 | Facility | None | $169.82 | $478.63 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $724.44 | Professional | None | $380.19 | $478.63 | $724.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $549.54 | Professional | None | $239.88 | $380.19 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $3,235.94 Typical High $4,365.16 | Facility | None | $389.05 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,023.29 | Professional | None | $416.87 | $416.87 | $1,023.29 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $5,248.07 | Facility | None | $549.54 | $1,862.09 | $5,248.07 |
United Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $1,000.00 | Professional | None | $288.40 | $416.87 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $380.19 Typical High $1,659.59 | Facility | None | $281.84 | $380.19 | $1,659.59 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $549.54 | Professional | None | $281.84 | $380.19 | $549.54 |
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 $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $302.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $302.00 Typical High $467.74 | Professional | 54 · Surgery only | $190.55 | $302.00 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $123.03 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $38.02 Typical High $58.88 | Professional | 56 · Pre-op care only | $23.99 | $38.02 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $263.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $165.96 | $263.03 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $213.80 | $316.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $190.55 | $302.00 | $436.52 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $223.87 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $38.02 Typical High $107.15 | Professional | 56 · Pre-op care only | $23.99 | $38.02 | $107.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $263.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $165.96 | $263.03 | $380.19 |
Where New York sits
The same service costs 8.1 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· 46th of 51
$389
AK $1,698TX $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.