How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $9,333Professionalmedian $347 · 10th to 90th $229 to $550
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $398.11 | Professional | None | $245.47 | $380.19 | $398.11 |
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 $309.03 Median $363.08 Typical High $457.09 | Professional | None | $309.03 | $363.08 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $691.83 | Professional | 50 · Both sides | $467.74 | $549.54 | $691.83 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $524.81 | Professional | None | $331.13 | $331.13 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,148.15 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $776.25 | Professional | None | $213.80 | $338.84 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $912.01 | Facility | None | $257.04 | $331.13 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $645.65 | Professional | None | $331.13 | $426.58 | $645.65 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $478.63 | Professional | None | $204.17 | $346.74 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $281.84 Median $3,235.94 Typical High $4,365.16 | Facility | None | $281.84 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $933.25 | Professional | None | $323.59 | $323.59 | $933.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $645.65 | Professional | None | $190.55 | $309.03 | $645.65 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $331.13 Typical High $1,096.48 | Facility | None | $158.49 | $331.13 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $478.63 | Professional | None | $239.88 | $331.13 | $478.63 |
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 $123.03 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $48.98 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $36.31 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $24.55 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $269.15 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $169.82 | $269.15 | $275.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $269.15 Typical High $371.54 | Professional | 54 · Surgery only | $162.18 | $269.15 | $371.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $72.44 Typical High $100.00 | Professional | 55 · Aftercare only | $43.65 | $72.44 | $100.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $20.42 | $34.67 | $47.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $234.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $141.25 | $234.42 | $331.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $281.84 | Professional | 53 · Discontinued | $194.98 | $199.53 | $281.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $269.15 Typical High $371.54 | Professional | 54 · Surgery only | $162.18 | $269.15 | $371.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $72.44 Typical High $186.21 | Professional | 55 · Aftercare only | $43.65 | $72.44 | $186.21 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $34.67 Typical High $89.13 | Professional | 56 · Pre-op care only | $20.42 | $34.67 | $89.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $234.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $141.25 | $234.42 | $331.13 |
Where New York sits
The same service costs 5.5 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· 35th of 51
$355
AK $1,202TX $219
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.