How much rates vary
Facilitymedian $3,311 · 10th to 90th $871 to $7,586Professionalmedian $447 · 10th to 90th $331 to $871
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 $1,380.38 Median $4,786.30 Typical High $8,317.64 | Facility | None | $1,380.38 | $4,786.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $691.83 | Professional | None | $426.58 | $549.54 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $977.24 | Professional | None | $371.54 | $436.52 | $977.24 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $741.31 | Professional | None | $512.86 | $512.86 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,148.15 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $1,023.29 | Professional | None | $281.84 | $489.78 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $1,380.38 | Facility | None | $363.08 | $489.78 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,071.52 | Professional | None | $575.44 | $630.96 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $707.95 | Professional | None | $354.81 | $457.09 | $707.95 |
MVP Health Care Setting Facility Modifier None Typical Low $371.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $371.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $912.01 | Professional | None | $524.81 | $524.81 | $912.01 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $6,760.83 | Facility | None | $851.14 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $776.25 | Professional | None | $275.42 | $436.52 | $776.25 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $478.63 Typical High $1,584.89 | Facility | None | $239.88 | $478.63 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $776.25 | Professional | None | $354.81 | $478.63 | $776.25 |
15 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 $213.80 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $213.80 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $316.23 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $295.12 | $380.19 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $457.09 Typical High $707.95 | Professional | 54 · Surgery only | $316.23 | $457.09 | $707.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $79.43 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $79.43 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $70.79 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $389.05 | Professional | 53 · Discontinued | $269.15 | $338.84 | $389.05 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $457.09 Typical High $707.95 | Professional | 54 · Surgery only | $316.23 | $457.09 | $707.95 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $79.43 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $79.43 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $70.79 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $70.79 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $645.65 |
Where New York sits
The same service costs 4.4 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· 48th of 51
$457
AK $1,950TX $447
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.