How much rates vary
Facilitymedian $3,890 · 10th to 90th $813 to $9,550Professionalmedian $380 · 10th to 90th $302 to $646
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | None | $446.68 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | None | $323.59 | $380.19 | $645.65 |
CDPHP Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $977.24 | Professional | None | $363.08 | $371.54 | $977.24 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $501.19 Typical High $1,621.81 | Facility | None | $295.12 | $501.19 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $870.96 | Professional | None | $407.38 | $489.78 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $575.44 | Professional | None | $288.40 | $389.05 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $4,365.16 | Facility | None | $436.52 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $691.83 | Professional | None | $169.82 | $169.82 | $691.83 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,995.26 Typical High $6,309.57 | Facility | None | $776.25 | $1,995.26 | $6,309.57 |
United Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $660.69 | Professional | None | $309.03 | $407.38 | $660.69 |
Univera Setting Facility Modifier None Typical Low $275.42 Median $407.38 Typical High $1,047.13 | Facility | None | $275.42 | $407.38 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $575.44 | Professional | None | $288.40 | $389.05 | $575.44 |
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 $223.87 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $363.08 | $363.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $346.74 Typical High $524.81 | Professional | 54 · Surgery only | $208.93 | $346.74 | $524.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $57.54 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $57.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $38.90 Typical High $57.54 | Professional | 56 · Pre-op care only | $23.44 | $38.90 | $57.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $309.03 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $186.21 | $309.03 | $457.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $302.00 Typical High $407.38 | Professional | 53 · Discontinued | $223.87 | $302.00 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $346.74 Typical High $524.81 | Professional | 54 · Surgery only | $208.93 | $346.74 | $524.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $83.18 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $83.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $38.90 Typical High $83.18 | Professional | 56 · Pre-op care only | $23.44 | $38.90 | $83.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $309.03 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $186.21 | $309.03 | $457.09 |
Where New York sits
The same service costs 5.5 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· 47th of 51
$380
AK $1,738UT $316
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.