How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,023 to $7,943Professionalmedian $513 · 10th to 90th $427 to $794
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | None | $660.69 | $660.69 | $776.25 |
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 $426.58 Median $501.19 Typical High $758.58 | Professional | None | $426.58 | $501.19 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $758.58 Typical High $1,122.02 | Professional | 50 · Both sides | $645.65 | $758.58 | $1,122.02 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $3,715.35 | Facility | None | $1,258.93 | $1,905.46 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $1,258.93 | Professional | None | $457.09 | $478.63 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $2,041.74 | Facility | None | $549.54 | $676.08 | $2,041.74 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $954.99 | Professional | None | $562.34 | $602.56 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $741.31 | Professional | None | $407.38 | $478.63 | $741.31 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $776.25 | Professional | None | $691.83 | $724.44 | $776.25 |
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 $389.05 Median $562.34 Typical High $870.96 | Professional | None | $389.05 | $562.34 | $870.96 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $1,995.26 | Facility | None | $426.58 | $549.54 | $1,995.26 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $741.31 | Professional | None | $407.38 | $478.63 | $741.31 |
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 $331.13 Median $331.13 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $549.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $389.05 Typical High $588.84 | Professional | 54 · Surgery only | $323.59 | $389.05 | $588.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $95.50 Typical High $147.91 | Professional | 55 · Aftercare only | $81.28 | $95.50 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $74.13 | Professional | 56 · Pre-op care only | $40.74 | $47.86 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $524.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $354.81 Typical High $501.19 | Professional | 53 · Discontinued | $281.84 | $354.81 | $501.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $398.11 Typical High $588.84 | Professional | 54 · Surgery only | $323.59 | $398.11 | $588.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $239.88 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $239.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $120.23 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $120.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $524.81 |
Where New York sits
The same service costs 8.5 times more in Wyoming 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· 46th of 51
$537
WY $2,512UT $295
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.