How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,202 to $7,762Professionalmedian $1,047 · 10th to 90th $832 to $1,950
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 $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
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 $851.14 Median $1,000.00 Typical High $1,412.54 | Professional | None | $851.14 | $1,000.00 | $1,412.54 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $3,235.94 | Facility | None | $1,174.90 | $1,905.46 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,071.52 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $4,365.16 | Facility | None | $1,174.90 | $1,548.82 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,318.26 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,318.26 | Professional | None | $812.83 | $1,000.00 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $38,018.94 | Facility | None | $4,786.30 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,148.15 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $2,884.03 | Professional | None | $707.95 | $1,318.26 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $977.24 Typical High $4,570.88 | Facility | None | $812.83 | $977.24 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,318.26 | Professional | None | $812.83 | $912.01 | $1,318.26 |
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 $524.81 Median $524.81 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $870.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $645.65 | $870.96 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $181.97 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $181.97 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $109.65 Typical High $154.88 | Professional | 56 · Pre-op care only | $91.20 | $109.65 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | 53 · Discontinued | $562.34 | $562.34 | $851.14 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $870.96 | $1,148.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $354.81 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $109.65 Typical High $302.00 | Professional | 56 · Pre-op care only | $91.20 | $109.65 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $1,000.00 |
Where New York sits
The same service costs 5.9 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· 44th of 51
$1,047
AK $4,467TX $759
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.