How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,047 to $7,586Professionalmedian $525 · 10th to 90th $427 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 $1,819.70 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $426.58 Median $501.19 Typical High $812.83 | Professional | None | $426.58 | $501.19 | $812.83 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,398.83 Typical High $4,897.79 | Facility | None | $1,148.15 | $2,398.83 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $1,047.13 | Professional | None | $478.63 | $489.78 | $1,047.13 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,238.72 | Facility | None | $512.86 | $691.83 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,202.26 | Professional | None | $537.03 | $676.08 | $1,202.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $776.25 | Professional | None | $389.05 | $537.03 | $776.25 |
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 $588.84 Median $588.84 Typical High $912.01 | Professional | None | $588.84 | $588.84 | $912.01 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,148.15 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $851.14 | Professional | None | $416.87 | $524.81 | $851.14 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $1,949.84 | Facility | None | $363.08 | $537.03 | $1,949.84 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $776.25 | Professional | None | $389.05 | $537.03 | $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 $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $478.63 Typical High $691.83 | Professional | 54 · Surgery only | $281.84 | $478.63 | $691.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $53.70 Typical High $77.62 | Professional | 55 · Aftercare only | $30.90 | $53.70 | $77.62 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $47.86 Typical High $69.18 | Professional | 56 · Pre-op care only | $28.18 | $47.86 | $69.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $436.52 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $251.19 | $436.52 | $616.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $389.05 Typical High $562.34 | Professional | 53 · Discontinued | $295.12 | $389.05 | $562.34 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $478.63 Typical High $691.83 | Professional | 54 · Surgery only | $281.84 | $478.63 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $53.70 Typical High $112.20 | Professional | 55 · Aftercare only | $30.90 | $53.70 | $112.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $47.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $28.18 | $47.86 | $100.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $436.52 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $251.19 | $436.52 | $616.60 |
Where New York sits
The same service costs 5.5 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· 47th of 51
$525
AK $2,344TX $427
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.