How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $70,795Professionalmedian $1,585 · 10th to 90th $1,047 to $3,090
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 $1,737.80 Median $81,283.05 Typical High $123,026.88 | Facility | None | $1,737.80 | $81,283.05 | $123,026.88 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,737.80 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $4,466.84 Typical High $79,432.82 | Facility | None | $1,288.25 | $4,466.84 | $79,432.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,621.81 | $2,818.38 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,981.07 | Facility | None | $851.14 | $1,778.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $6,918.31 | Professional | None | $1,318.26 | $1,380.38 | $6,918.31 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $1,479.11 Typical High $5,248.07 | Facility | None | $524.81 | $1,479.11 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,778.28 | $3,090.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $1,737.80 | Professional | None | $660.69 | $1,230.27 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $47,863.01 Typical High $97,723.72 | Facility | None | $4,786.30 | $47,863.01 | $97,723.72 |
MVP Health Care Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $3,630.78 | Professional | None | $575.44 | $575.44 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,122.02 | $1,819.70 | $4,365.16 |
Univera Setting Facility Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $4,466.84 | Facility | None | $1,230.27 | $1,318.26 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $1,737.80 | Professional | None | $660.69 | $1,230.27 | $1,737.80 |
9 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 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,513.56 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $194.98 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $1,348.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,513.56 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $346.74 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $295.12 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $1,318.26 |
Where New York sits
The same service costs 5.7 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $13,752KY $2,420
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.