How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,622 to $14,125Professionalmedian $1,380 · 10th to 90th $1,122 to $2,754
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 $1,659.59 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,659.59 | $1,659.59 | $3,311.31 |
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 $1,122.02 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,318.26 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,949.84 Typical High $3,388.44 | Professional | 50 · Both sides | $1,659.59 | $1,949.84 | $3,388.44 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,737.80 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,801.89 | Professional | None | $1,659.59 | $1,659.59 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,819.70 | $2,454.71 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,778.28 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,187.76 | Professional | None | $933.25 | $1,445.44 | $2,187.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $1,778.28 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,778.28 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,995.26 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,168.69 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,698.24 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $4,786.30 | Facility | None | $1,122.02 | $1,548.82 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,445.44 | $2,187.76 |
13 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 $1,230.27 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,737.80 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $302.00 Typical High $457.09 | Professional | 55 · Aftercare only | $199.53 | $302.00 | $457.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $144.54 Typical High $218.78 | Professional | 56 · Pre-op care only | $93.33 | $144.54 | $218.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,000.00 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $645.65 | $1,000.00 | $1,513.56 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $891.25 Typical High $1,318.26 | Professional | 53 · Discontinued | $870.96 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,737.80 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $302.00 Typical High $912.01 | Professional | 55 · Aftercare only | $199.53 | $302.00 | $912.01 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $144.54 Typical High $426.58 | Professional | 56 · Pre-op care only | $93.33 | $144.54 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,000.00 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $645.65 | $1,000.00 | $1,548.82 |
Where New York sits
The same service costs 7.8 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
$1,413
AK $6,761TX $871
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.