How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,445 to $14,125Professionalmedian $1,072 · 10th to 90th $891 to $1,738
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 $10,471.29 | Facility | None | $1,819.70 | $5,623.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,071.52 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,819.70 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,412.54 | Professional | None | $954.99 | $1,122.02 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,659.59 Typical High $2,089.30 | Professional | 50 · Both sides | $1,412.54 | $1,659.59 | $2,089.30 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,698.24 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,047.13 | $2,398.83 |
Emblem Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $3,801.89 | Facility | None | $1,174.90 | $1,513.56 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,819.70 | Professional | None | $977.24 | $1,174.90 | $1,819.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,380.38 | Professional | None | $602.56 | $933.25 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,096.48 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,096.48 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,230.27 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,073.80 Typical High $13,803.84 | Facility | None | $1,348.96 | $4,073.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $2,570.40 | Professional | None | $707.95 | $1,071.52 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $977.24 Typical High $3,235.94 | Facility | None | $707.95 | $977.24 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | None | $707.95 | $933.25 | $1,380.38 |
12 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 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | 54 · Surgery only | $478.63 | $741.31 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $288.40 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $288.40 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | 54 · Surgery only | $478.63 | $741.31 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $575.44 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $575.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $275.42 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $977.24 |
Where New York sits
The same service costs 7.6 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· 42nd of 51
$1,096
AK $4,266TX $562
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.