How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,715Professionalmedian $501 · 10th to 90th $417 to $871
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 $549.54 Median $549.54 Typical High $575.44 | Professional | None | $549.54 | $549.54 | $575.44 |
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 $416.87 Median $489.78 Typical High $707.95 | Professional | None | $416.87 | $489.78 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $741.31 Typical High $1,071.52 | Professional | 50 · Both sides | $630.96 | $741.31 | $1,071.52 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $537.03 Median $537.03 Typical High $1,230.27 | Professional | None | $537.03 | $537.03 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $562.34 Median $776.25 Typical High $2,187.76 | Facility | None | $562.34 | $776.25 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $933.25 | Professional | None | $501.19 | $630.96 | $933.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $724.44 | Professional | None | $309.03 | $501.19 | $724.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $537.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $537.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,348.96 | Professional | None | $512.86 | $512.86 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,318.26 | Professional | None | $371.54 | $549.54 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $1,995.26 | Facility | None | $363.08 | $501.19 | $1,995.26 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Professional | None | $363.08 | $501.19 | $724.44 |
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 $275.42 Median $275.42 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $416.87 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $398.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $245.47 | $389.05 | $575.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $104.71 Typical High $151.36 | Professional | 55 · Aftercare only | $66.07 | $104.71 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $50.12 Typical High $72.44 | Professional | 56 · Pre-op care only | $30.90 | $50.12 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $346.74 | $501.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | 53 · Discontinued | $281.84 | $281.84 | $416.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $245.47 | $389.05 | $575.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $104.71 Typical High $302.00 | Professional | 55 · Aftercare only | $66.07 | $104.71 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $50.12 Typical High $141.25 | Professional | 56 · Pre-op care only | $30.90 | $50.12 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $346.74 | $501.19 |
Where New York sits
The same service costs 7.9 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
$525
AK $2,239TX $282
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.