How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,233Professionalmedian $1,202 · 10th to 90th $447 to $2,291
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 $1,698.24 Median $5,754.40 Typical High $11,748.98 | Facility | None | $1,698.24 | $5,754.40 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,479.11 Typical High $1,737.80 | Professional | None | $436.52 | $1,479.11 | $1,737.80 |
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 $1,000.00 Median $1,202.26 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,202.26 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $3,467.37 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $3,467.37 |
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 $537.03 Median $537.03 Typical High $1,905.46 | Professional | None | $537.03 | $537.03 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,621.81 | $2,754.23 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $1,047.13 Typical High $2,511.89 | Professional | None | $323.59 | $1,047.13 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $398.11 Median $478.63 Typical High $1,513.56 | Facility | None | $398.11 | $478.63 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,698.24 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,698.24 | Professional | None | $776.25 | $1,202.26 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $380.19 Median $3,235.94 Typical High $4,365.16 | Facility | None | $380.19 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,949.84 | $1,949.84 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $346.74 Median $1,122.02 Typical High $2,454.71 | Professional | None | $346.74 | $1,122.02 | $2,454.71 |
Univera Setting Facility Modifier None Typical Low $269.15 Median $1,202.26 Typical High $3,715.35 | Facility | None | $269.15 | $1,202.26 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,698.24 | Professional | None | $776.25 | $1,202.26 | $1,698.24 |
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 $218.78 Median $645.65 Typical High $870.96 | Professional | 52 · Reduced service | $218.78 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $257.04 Typical High $346.74 | Professional | 53 · Discontinued | $87.10 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $954.99 Typical High $1,318.26 | Professional | 54 · Surgery only | $323.59 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $194.98 Typical High $263.03 | Professional | 55 · Aftercare only | $64.57 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $128.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $43.65 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $891.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $302.00 | $891.25 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,548.82 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 55 · Aftercare only | $77.62 | $125.89 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 56 · Pre-op care only | $77.62 | $125.89 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,023.29 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $630.96 | $1,023.29 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,148.15 Typical High $1,513.56 | Professional | 54 · Surgery only | $707.95 | $1,148.15 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 55 · Aftercare only | $77.62 | $125.89 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 56 · Pre-op care only | $77.62 | $125.89 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,023.29 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $630.96 | $1,023.29 | $1,348.96 |
Where New York sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 40th of 51
$1,259
AK $3,020NE $692
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.