How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,096 to $10,715Professionalmedian $407 · 10th to 90th $309 to $1,023
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 $5,754.40 Typical High $11,481.54 | Facility | None | $1,819.70 | $5,754.40 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,659.59 | Professional | None | $436.52 | $436.52 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,513.56 | $4,570.88 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $724.44 | Professional | None | $323.59 | $389.05 | $724.44 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $7,244.36 | Facility | None | $1,737.80 | $3,548.13 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $1,348.96 | Professional | None | $398.11 | $407.38 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $1,479.11 | Facility | None | $436.52 | $602.56 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $758.58 | Professional | None | $398.11 | $457.09 | $758.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $645.65 | Professional | None | $263.03 | $338.84 | $645.65 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $4,365.16 Typical High $89,125.09 | Facility | None | $489.78 | $4,365.16 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $691.83 Median $1,548.82 Typical High $1,548.82 | Professional | None | $691.83 | $1,548.82 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $1,174.90 | Professional | None | $302.00 | $457.09 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $724.44 | Facility | None | $263.03 | $371.54 | $724.44 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $645.65 | Professional | None | $263.03 | $338.84 | $645.65 |
18 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 $218.78 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $316.23 Typical High $616.60 | Professional | 54 · Surgery only | $245.47 | $316.23 | $616.60 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $45.71 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $45.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $58.88 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $281.84 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $223.87 | $281.84 | $549.54 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $616.60 | Facility | 54 · Surgery only | $245.47 | $338.84 | $616.60 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $45.71 | Facility | 55 · Aftercare only | $18.62 | $28.18 | $45.71 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $58.88 | Facility | 56 · Pre-op care only | $23.99 | $36.31 | $58.88 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $338.84 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $223.87 | $338.84 | $549.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $371.54 Typical High $616.60 | Professional | 54 · Surgery only | $245.47 | $371.54 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $18.62 | $32.36 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $23.99 | $41.69 | $66.07 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $371.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $223.87 | $371.54 | $549.54 |
Where New York sits
The same service costs 5.5 times more in Alaska than in Kentucky. 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
$437
AK $2,188KY $398
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.