How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,233Professionalmedian $468 · 10th to 90th $380 to $955
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,621.81 | Professional | None | $562.34 | $562.34 | $1,621.81 |
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 $380.19 Median $457.09 Typical High $870.96 | Professional | None | $380.19 | $457.09 | $870.96 |
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 $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,348.96 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $1,621.81 | Professional | None | $407.38 | $426.58 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $1,995.26 | Facility | None | $512.86 | $870.96 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,071.52 | Professional | None | $537.03 | $602.56 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $691.83 | Professional | None | $309.03 | $446.68 | $691.83 |
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 $616.60 Median $616.60 Typical High $1,230.27 | Professional | None | $616.60 | $616.60 | $1,230.27 |
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 $407.38 Median $549.54 Typical High $1,412.54 | Professional | None | $407.38 | $549.54 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $2,691.53 | Facility | None | $338.84 | $446.68 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $691.83 | Professional | None | $309.03 | $446.68 | $691.83 |
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 $275.42 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $416.87 Typical High $660.69 | Professional | 54 · Surgery only | $295.12 | $416.87 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $31.62 Typical High $50.12 | Professional | 55 · Aftercare only | $22.39 | $31.62 | $50.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $40.74 Typical High $64.57 | Professional | 56 · Pre-op care only | $28.84 | $40.74 | $64.57 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $380.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $269.15 | $380.19 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $416.87 Typical High $645.65 | Professional | 54 · Surgery only | $295.12 | $416.87 | $645.65 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $31.62 Typical High $64.57 | Professional | 55 · Aftercare only | $22.39 | $31.62 | $64.57 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $40.74 Typical High $83.18 | Professional | 56 · Pre-op care only | $28.84 | $40.74 | $83.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $269.15 | $380.19 | $575.44 |
Where New York sits
The same service costs 5.4 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· 50th of 51
$513
AK $2,630TX $490
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.