How much rates vary
Facilitymedian $3,311 · 10th to 90th $977 to $7,586Professionalmedian $537 · 10th to 90th $347 to $871
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 $338.84 Median $537.03 Typical High $616.60 | Professional | None | $338.84 | $537.03 | $616.60 |
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 $457.09 Median $537.03 Typical High $776.25 | Professional | None | $457.09 | $537.03 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $812.83 Typical High $1,148.15 | Professional | 50 · Both sides | $691.83 | $812.83 | $1,148.15 |
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 $489.78 Median $489.78 Typical High $851.14 | Professional | None | $489.78 | $489.78 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $3,981.07 | Facility | None | $1,148.15 | $1,949.84 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $1,288.25 | Professional | None | $346.74 | $575.44 | $1,288.25 |
Emblem Health Setting Facility Modifier None Typical Low $323.59 Median $436.52 Typical High $1,412.54 | Facility | None | $323.59 | $436.52 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,148.15 | Professional | None | $537.03 | $758.58 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $758.58 | Professional | None | $331.13 | $575.44 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $323.59 Median $3,235.94 Typical High $4,365.16 | Facility | None | $323.59 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,412.54 | Professional | None | $354.81 | $354.81 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $1,023.29 | Professional | None | $281.84 | $489.78 | $1,023.29 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $537.03 Typical High $1,258.93 | Facility | None | $239.88 | $537.03 | $1,258.93 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $758.58 | Professional | None | $389.05 | $537.03 | $758.58 |
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 $169.82 Median $239.88 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $67.61 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $251.19 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $51.29 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.88 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $234.42 | $338.84 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $446.68 Typical High $645.65 | Professional | 54 · Surgery only | $263.03 | $446.68 | $645.65 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $120.23 Typical High $169.82 | Professional | 55 · Aftercare only | $69.18 | $120.23 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $57.54 Typical High $81.28 | Professional | 56 · Pre-op care only | $33.11 | $57.54 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $398.11 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $229.09 | $398.11 | $562.34 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $446.68 | Professional | 53 · Discontinued | $302.00 | $309.03 | $446.68 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $263.03 | $478.63 | $602.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $125.89 Typical High $263.03 | Professional | 55 · Aftercare only | $69.18 | $125.89 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $60.26 Typical High $123.03 | Professional | 56 · Pre-op care only | $33.11 | $60.26 | $123.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $229.09 | $416.87 | $537.03 |
Where New York sits
The same service costs 4.7 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
$537
AK $1,660TX $355
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.