How much rates vary
Facilitymedian $3,162 · 10th to 90th $661 to $7,413Professionalmedian $380 · 10th to 90th $209 to $525
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $371.54 | Professional | None | $251.19 | $316.23 | $371.54 |
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 $389.05 Median $457.09 Typical High $524.81 | Professional | None | $389.05 | $457.09 | $524.81 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $501.19 | Professional | None | $316.23 | $316.23 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $1,778.28 | Facility | None | $346.74 | $676.08 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $562.34 | Professional | None | $173.78 | $275.42 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $831.76 | Facility | None | $223.87 | $269.15 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $776.25 | Professional | None | $457.09 | $457.09 | $776.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $467.74 | Professional | None | $234.42 | $309.03 | $467.74 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $524.81 | Professional | None | $346.74 | $346.74 | $524.81 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $446.68 | Professional | None | $169.82 | $269.15 | $446.68 |
Univera Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $1,047.13 | Facility | None | $144.54 | $263.03 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $457.09 | Professional | None | $234.42 | $309.03 | $457.09 |
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 $125.89 Median $144.54 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $57.54 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $257.04 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $323.59 Typical High $416.87 | Professional | 54 · Surgery only | $173.78 | $323.59 | $416.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $19.05 | $35.48 | $46.77 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $35.48 Typical High $46.77 | Professional | 56 · Pre-op care only | $19.05 | $35.48 | $46.77 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $288.40 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $151.36 | $288.40 | $371.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $229.09 Typical High $323.59 | Professional | 53 · Discontinued | $177.83 | $229.09 | $323.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $275.42 Typical High $416.87 | Professional | 54 · Surgery only | $173.78 | $275.42 | $416.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $35.48 Typical High $74.13 | Professional | 55 · Aftercare only | $19.05 | $35.48 | $74.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $35.48 Typical High $74.13 | Professional | 56 · Pre-op care only | $19.05 | $35.48 | $74.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $263.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $151.36 | $263.03 | $371.54 |
Where New York sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 20th of 51
$398
AK $912NJ $251
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.