How much rates vary
Facilitymedian $3,311 · 10th to 90th $741 to $7,586Professionalmedian $363 · 10th to 90th $282 to $589
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 $1,318.26 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $575.44 | Professional | None | $371.54 | $457.09 | $575.44 |
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 $309.03 Median $363.08 Typical High $575.44 | Professional | None | $309.03 | $363.08 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $870.96 | Professional | 50 · Both sides | $467.74 | $549.54 | $870.96 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $741.31 Typical High $1,778.28 | Facility | None | $407.38 | $741.31 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $758.58 | Professional | None | $269.15 | $354.81 | $758.58 |
Emblem Health Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $1,174.90 | Facility | None | $208.93 | $346.74 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $812.83 | Professional | None | $389.05 | $524.81 | $812.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $562.34 | Professional | None | $204.17 | $371.54 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $309.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $575.44 | Professional | None | $281.84 | $281.84 | $575.44 |
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 $269.15 Median $380.19 Typical High $575.44 | Professional | None | $269.15 | $380.19 | $575.44 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $1,288.25 | Facility | None | $323.59 | $389.05 | $1,288.25 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $562.34 | Professional | None | $204.17 | $371.54 | $562.34 |
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 $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $323.59 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $281.84 | $338.84 | $446.68 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $112.20 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $56.23 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $56.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $398.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $263.03 Typical High $380.19 | Professional | 53 · Discontinued | $208.93 | $263.03 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $281.84 | $338.84 | $446.68 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $181.97 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $181.97 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $91.20 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $91.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $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· 44th of 51
$372
AK $1,380UT $275
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.