How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,514 to $14,791Professionalmedian $1,202 · 10th to 90th $977 to $2,089
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,778.28 Typical High $2,570.40 | Professional | 50 · Both sides | $1,513.56 | $1,778.28 | $2,570.40 |
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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $13,803.84 Typical High $27,542.29 | Facility | None | $1,737.80 | $13,803.84 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,258.93 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $4,570.88 | Facility | None | $1,412.54 | $1,819.70 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,412.54 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,698.24 | Professional | None | $724.44 | $1,122.02 | $1,698.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,803.84 | Facility | None | $13,489.63 | $13,489.63 | $13,803.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,479.11 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,168.69 | $14,454.40 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $3,090.30 | Professional | None | $851.14 | $1,318.26 | $3,090.30 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $3,630.78 | Facility | None | $851.14 | $1,174.90 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
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 $977.24 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $891.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $575.44 | $891.25 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $380.19 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $380.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $112.20 Typical High $181.97 | Professional | 56 · Pre-op care only | $72.44 | $112.20 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $776.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $501.19 | $776.25 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $575.44 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $676.08 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $676.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $112.20 Typical High $323.59 | Professional | 56 · Pre-op care only | $72.44 | $112.20 | $323.59 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $776.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $501.19 | $776.25 | $1,174.90 |
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
$1,259
AK $5,248TX $646
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.