How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,445 to $11,482Professionalmedian $1,380 · 10th to 90th $1,096 to $2,951
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 $5,370.32 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,370.32 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,570.88 | Professional | None | $1,513.56 | $1,513.56 | $4,570.88 |
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 $1,148.15 Median $1,348.96 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,348.96 | $2,754.23 |
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,737.80 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $5,495.41 | Professional | None | $1,122.02 | $1,548.82 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $5,128.61 | Facility | None | $1,148.15 | $1,621.81 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,621.81 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,348.96 | $1,905.46 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,698.24 | $1,698.24 | $3,890.45 |
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 $1,071.52 Median $1,513.56 Typical High $4,073.80 | Professional | None | $1,071.52 | $1,513.56 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,348.96 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,348.96 | $1,819.70 |
14 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 $758.58 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,096.48 Typical High $1,621.81 | Professional | 54 · Surgery only | $870.96 | $1,096.48 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $177.83 Typical High $263.03 | Professional | 55 · Aftercare only | $141.25 | $177.83 | $263.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $125.89 Typical High $190.55 | Professional | 56 · Pre-op care only | $100.00 | $125.89 | $190.55 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $977.24 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $758.58 | $977.24 | $1,445.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,122.02 Typical High $1,584.89 | Professional | 54 · Surgery only | $870.96 | $1,122.02 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $181.97 Typical High $407.38 | Professional | 55 · Aftercare only | $141.25 | $181.97 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $295.12 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $977.24 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $758.58 | $977.24 | $1,412.54 |
Where New York sits
The same service costs 7.1 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· 47th of 51
$1,413
AK $6,026TX $851
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.