How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,233Professionalmedian $1,288 · 10th to 90th $389 to $2,570
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 $5,888.44 Typical High $11,748.98 | Facility | None | $1,819.70 | $5,888.44 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,258.93 Typical High $2,089.30 | Professional | None | $331.13 | $1,258.93 | $2,089.30 |
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 $1,071.52 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,288.25 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,949.84 Typical High $3,890.45 | Professional | 50 · Both sides | $1,621.81 | $1,949.84 | $3,890.45 |
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 $467.74 Median $467.74 Typical High $2,238.72 | Professional | None | $467.74 | $467.74 | $2,238.72 |
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 $281.84 Median $1,047.13 Typical High $2,884.03 | Professional | None | $281.84 | $1,047.13 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $1,318.26 | Facility | None | $346.74 | $416.87 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,041.74 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,995.26 | Professional | None | $891.25 | $1,412.54 | $1,995.26 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $489.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $3,715.35 | Professional | None | $2,511.89 | $2,570.40 | $3,715.35 |
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 $302.00 Median $1,202.26 Typical High $2,691.53 | Professional | None | $302.00 | $1,202.26 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $1,047.13 Typical High $4,786.30 | Facility | None | $234.42 | $1,047.13 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,995.26 | Professional | None | $891.25 | $1,412.54 | $1,995.26 |
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 $165.96 Median $616.60 Typical High $1,023.29 | Professional | 52 · Reduced service | $165.96 | $616.60 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $251.19 Typical High $407.38 | Professional | 53 · Discontinued | $67.61 | $251.19 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $933.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $251.19 | $933.25 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $186.21 Typical High $302.00 | Professional | 55 · Aftercare only | $50.12 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $125.89 Typical High $204.17 | Professional | 56 · Pre-op care only | $33.11 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $870.96 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $234.42 | $870.96 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,318.26 Typical High $1,819.70 | Professional | 54 · Surgery only | $831.76 | $1,318.26 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $147.91 Typical High $204.17 | Professional | 55 · Aftercare only | $91.20 | $147.91 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $147.91 Typical High $204.17 | Professional | 56 · Pre-op care only | $91.20 | $147.91 | $204.17 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,348.96 Typical High $1,778.28 | Professional | 54 · Surgery only | $831.76 | $1,348.96 | $1,778.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $223.87 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $151.36 Typical High $223.87 | Professional | 56 · Pre-op care only | $91.20 | $151.36 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,202.26 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $741.31 | $1,202.26 | $1,584.89 |
Where New York sits
The same service costs 5.8 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· 43rd of 51
$1,318
AK $3,548NE $617
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.