How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,230 to $9,550Professionalmedian $1,349 · 10th to 90th $1,047 to $2,754
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,513.56 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $4,365.16 Typical High $10,715.19 | Facility | None | $1,445.44 | $4,365.16 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,348.96 | $2,570.40 |
CDPHP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,570.88 | Professional | None | $1,202.26 | $1,202.26 | $4,570.88 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $5,128.61 | Facility | None | $954.99 | $1,621.81 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,698.24 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,995.26 | Professional | None | $851.14 | $1,230.27 | $1,995.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,348.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $3,630.78 | Professional | None | $676.08 | $676.08 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,344.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,584.89 | $4,168.69 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $4,073.80 | Facility | None | $1,000.00 | $1,318.26 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,995.26 | Professional | None | $851.14 | $1,230.27 | $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 $758.58 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,148.15 Typical High $1,949.84 | Professional | 54 · Surgery only | $870.96 | $1,148.15 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $144.54 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $112.20 Typical High $186.21 | Professional | 56 · Pre-op care only | $85.11 | $112.20 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,047.13 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $794.33 | $1,047.13 | $1,737.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,174.90 Typical High $1,862.09 | Professional | 54 · Surgery only | $870.96 | $1,174.90 | $1,862.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $89.13 Typical High $190.55 | Professional | 55 · Aftercare only | $66.07 | $89.13 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $114.82 Typical High $245.47 | Professional | 56 · Pre-op care only | $85.11 | $114.82 | $245.47 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,071.52 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $794.33 | $1,071.52 | $1,698.24 |
Where New York sits
The same service costs 5.2 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· 45th of 51
$1,413
AK $5,623TX $1,072
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.