How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,413 to $11,482Professionalmedian $1,072 · 10th to 90th $851 to $2,630
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,174.90 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $2,454.71 | Professional | None | $851.14 | $1,000.00 | $2,454.71 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,584.89 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $4,897.79 | Professional | None | $1,000.00 | $1,318.26 | $4,897.79 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $5,011.87 | Facility | None | $1,000.00 | $1,584.89 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,621.81 | $2,630.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $891.25 | $1,230.27 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,202.26 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $3,715.35 | Professional | None | $977.24 | $1,380.38 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,511.89 | Facility | None | $977.24 | $1,258.93 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $891.25 | $1,230.27 | $1,698.24 |
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 $588.84 Median $588.84 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $588.84 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $323.59 | Professional | 53 · Discontinued | $234.42 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,548.82 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $173.78 Typical High $251.19 | Professional | 55 · Aftercare only | $125.89 | $173.78 | $251.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $181.97 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $933.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $676.08 | $933.25 | $1,380.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $891.25 Typical High $1,348.96 | Professional | 53 · Discontinued | $660.69 | $891.25 | $1,348.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,445.44 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,445.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $173.78 Typical High $363.08 | Professional | 55 · Aftercare only | $125.89 | $173.78 | $363.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $257.04 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $933.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $676.08 | $933.25 | $1,288.25 |
Where New York sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 49th of 51
$1,096
AK $5,495UT $933
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.