How much rates vary
Facilitymedian $3,388 · 10th to 90th $759 to $8,128Professionalmedian $417 · 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 $1,621.81 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 $407.38 Median $501.19 Typical High $1,000.00 | Professional | None | $407.38 | $501.19 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $8,317.64 | Facility | None | $1,288.25 | $3,981.07 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $794.33 | Professional | None | $338.84 | $398.11 | $794.33 |
CDPHP Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $524.81 Median $562.34 Typical High $1,659.59 | Professional | None | $524.81 | $562.34 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $1,621.81 | Facility | None | $467.74 | $758.58 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $831.76 | Professional | None | $436.52 | $501.19 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $602.56 | Professional | None | $309.03 | $380.19 | $602.56 |
MVP Health Care Setting Facility Modifier None Typical Low $501.19 Median $3,235.94 Typical High $4,365.16 | Facility | None | $501.19 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,096.48 | Professional | None | $549.54 | $549.54 | $1,096.48 |
United Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $9,120.11 | Facility | None | $575.44 | $2,187.76 | $9,120.11 |
United Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $1,122.02 | Professional | None | $331.13 | $512.86 | $1,122.02 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $398.11 Typical High $1,479.11 | Facility | None | $363.08 | $398.11 | $1,479.11 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $549.54 | Professional | None | $309.03 | $380.19 | $549.54 |
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 $204.17 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $354.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $275.42 Typical High $478.63 | Professional | 54 · Surgery only | $234.42 | $275.42 | $478.63 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $141.25 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $141.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $104.71 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $104.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $371.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $288.40 Typical High $426.58 | Professional | 53 · Discontinued | $213.80 | $288.40 | $426.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $275.42 Typical High $457.09 | Professional | 54 · Surgery only | $234.42 | $275.42 | $457.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $190.55 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $141.25 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $398.11 |
Where New York sits
The same service costs 5.0 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· 45th of 51
$427
AK $1,349UT $269
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.