How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,148 to $10,965Professionalmedian $389 · 10th to 90th $316 to $933
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 $1,513.56 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,513.56 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,288.25 | Professional | None | $467.74 | $467.74 | $1,288.25 |
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 $316.23 Median $371.54 Typical High $851.14 | Professional | None | $316.23 | $371.54 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $1,288.25 | Professional | 50 · Both sides | $467.74 | $549.54 | $1,288.25 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,148.15 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,698.24 | Professional | None | $371.54 | $562.34 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $1,737.80 | Facility | None | $416.87 | $537.03 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $912.01 | Professional | None | $478.63 | $549.54 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $602.56 | Professional | None | $316.23 | $426.58 | $602.56 |
MVP Health Care Setting Facility Modifier None Typical Low $446.68 Median $3,235.94 Typical High $4,365.16 | Facility | None | $446.68 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,122.02 | Professional | None | $457.09 | $457.09 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $1,258.93 | Professional | None | $338.84 | $478.63 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $346.74 Median $436.52 Typical High $1,412.54 | Facility | None | $346.74 | $436.52 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $588.84 | Professional | None | $316.23 | $426.58 | $588.84 |
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 $234.42 Median $234.42 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $363.08 Typical High $549.54 | Professional | 54 · Surgery only | $275.42 | $363.08 | $549.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $58.88 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $58.88 | $89.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $64.57 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $323.59 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $239.88 | $323.59 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $302.00 Typical High $478.63 | Professional | 53 · Discontinued | $229.09 | $302.00 | $478.63 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $275.42 | $363.08 | $512.86 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $58.88 Typical High $128.82 | Professional | 55 · Aftercare only | $44.67 | $58.88 | $128.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $93.33 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $93.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $323.59 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $239.88 | $323.59 | $457.09 |
Where New York sits
The same service costs 5.8 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $8,557MT $1,467
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.