How much rates vary
Facilitymedian $3,311 · 10th to 90th $851 to $7,586Professionalmedian $316 · 10th to 90th $251 to $813
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 $794.33 Median $4,466.84 Typical High $8,128.31 | Facility | None | $794.33 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $794.33 | Professional | None | $338.84 | $398.11 | $794.33 |
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 $251.19 Median $295.12 Typical High $707.95 | Professional | None | $251.19 | $295.12 | $707.95 |
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 $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
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 $213.80 Median $363.08 Typical High $1,318.26 | Professional | None | $213.80 | $363.08 | $1,318.26 |
Emblem Health Setting Facility Modifier None Typical Low $288.40 Median $331.13 Typical High $1,096.48 | Facility | None | $288.40 | $331.13 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $776.25 | Professional | None | $416.87 | $467.74 | $776.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $562.34 | Professional | None | $251.19 | $363.08 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $316.23 Median $3,235.94 Typical High $4,365.16 | Facility | None | $316.23 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $831.76 | Professional | None | $316.23 | $316.23 | $831.76 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,148.15 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $933.25 | Professional | None | $229.09 | $354.81 | $933.25 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $338.84 Typical High $1,096.48 | Facility | None | $181.97 | $338.84 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $562.34 | Professional | None | $251.19 | $338.84 | $562.34 |
16 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 $173.78 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $257.04 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $323.59 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 51 · Multiple procedures | $194.98 | $194.98 | $194.98 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $223.87 | $331.13 | $512.86 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $56.23 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $56.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.11 Typical High $51.29 | Professional | 56 · Pre-op care only | $22.39 | $33.11 | $51.29 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $204.17 | $295.12 | $457.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $257.04 Typical High $380.19 | Professional | 53 · Discontinued | $190.55 | $257.04 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $223.87 | $331.13 | $512.86 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $72.44 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $72.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.11 Typical High $66.07 | Professional | 56 · Pre-op care only | $22.39 | $33.11 | $66.07 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $204.17 | $295.12 | $457.09 |
Where New York sits
The same service costs 4.9 times more in Alaska than in Utah. 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
$324
AK $1,479UT $302
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.