How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,000Professionalmedian $631 · 10th to 90th $501 to $1,072
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 $1,698.24 Median $5,623.41 Typical High $10,471.29 | Facility | None | $1,698.24 | $5,623.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $2,187.76 | Professional | None | $660.69 | $660.69 | $2,187.76 |
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 $524.81 Median $616.60 Typical High $851.14 | Professional | None | $524.81 | $616.60 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $1,288.25 | Professional | 50 · Both sides | $776.25 | $912.01 | $1,288.25 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,621.81 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,445.44 | Professional | None | $630.96 | $630.96 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $912.01 Typical High $2,511.89 | Facility | None | $660.69 | $912.01 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,096.48 | Professional | None | $588.84 | $616.60 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $851.14 | Professional | None | $363.08 | $575.44 | $851.14 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $5,754.40 Typical High $15,848.93 | Facility | None | $645.65 | $5,754.40 | $15,848.93 |
MVP Health Care Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,621.81 | Professional | None | $660.69 | $831.76 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,235.94 | $9,549.93 |
United Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,548.82 | Professional | None | $436.52 | $660.69 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,511.89 | Facility | None | $426.58 | $588.84 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $851.14 | Professional | None | $426.58 | $575.44 | $851.14 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $467.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $457.09 Typical High $691.83 | Professional | 54 · Surgery only | $288.40 | $457.09 | $691.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $181.97 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $181.97 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $57.54 Typical High $87.10 | Professional | 56 · Pre-op care only | $36.31 | $57.54 | $87.10 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $398.11 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $251.19 | $398.11 | $602.56 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $489.78 | Professional | 53 · Discontinued | $331.13 | $338.84 | $489.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $457.09 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $457.09 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $346.74 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $57.54 Typical High $165.96 | Professional | 56 · Pre-op care only | $36.31 | $57.54 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $251.19 | $398.11 | $588.84 |
Where New York sits
The same service costs 7.4 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
$631
AK $2,630TX $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.