How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,096 to $10,233Professionalmedian $380 · 10th to 90th $309 to $646
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 $1,819.70 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | None | $398.11 | $398.11 | $407.38 |
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 $323.59 Median $380.19 Typical High $549.54 | Professional | None | $323.59 | $380.19 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $575.44 Typical High $794.33 | Professional | 50 · Both sides | $489.78 | $575.44 | $794.33 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,318.26 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $891.25 | Professional | None | $380.19 | $380.19 | $891.25 |
Emblem Health Setting Facility Modifier None Typical Low $316.23 Median $478.63 Typical High $1,513.56 | Facility | None | $316.23 | $478.63 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $691.83 | Professional | None | $354.81 | $389.05 | $691.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $524.81 | Professional | None | $223.87 | $363.08 | $524.81 |
MVP Health Care Setting Facility Modifier None Typical Low $380.19 Median $3,235.94 Typical High $4,365.16 | Facility | None | $380.19 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $977.24 | Professional | None | $363.08 | $363.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $954.99 | Professional | None | $269.15 | $398.11 | $954.99 |
Univera Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $1,412.54 | Facility | None | $269.15 | $354.81 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $524.81 | Professional | None | $269.15 | $354.81 | $524.81 |
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 $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $281.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $288.40 Typical High $416.87 | Professional | 54 · Surgery only | $177.83 | $288.40 | $416.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $47.86 | $77.62 | $109.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $22.39 | $36.31 | $52.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $251.19 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $154.88 | $251.19 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $204.17 Typical High $302.00 | Professional | 53 · Discontinued | $199.53 | $204.17 | $302.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $288.40 Typical High $416.87 | Professional | 54 · Surgery only | $177.83 | $288.40 | $416.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $77.62 Typical High $218.78 | Professional | 55 · Aftercare only | $47.86 | $77.62 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $36.31 Typical High $102.33 | Professional | 56 · Pre-op care only | $22.39 | $36.31 | $102.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $251.19 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $154.88 | $251.19 | $363.08 |
Where New York sits
The same service costs 7.2 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· 45th of 51
$389
AK $1,622TX $224
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.