How much rates vary
Facilitymedian $2,818 · 10th to 90th $479 to $5,888Professionalmedian $295 · 10th to 90th $224 to $427
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 $5,754.40 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $407.38 | Professional | None | $295.12 | $331.13 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $407.38 | Professional | None | $251.19 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $436.52 Typical High $616.60 | Professional | 50 · Both sides | $371.54 | $436.52 | $616.60 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $436.52 | Professional | None | $346.74 | $346.74 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $1,479.11 | Facility | None | $257.04 | $457.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $549.54 | Professional | None | $194.98 | $245.47 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $851.14 | Facility | None | $239.88 | $309.03 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $562.34 | Professional | None | $269.15 | $371.54 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $407.38 | Professional | None | $199.53 | $263.03 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $4,365.16 | Facility | None | $436.52 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | None | $371.54 | $371.54 | $426.58 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $4,897.79 | Facility | None | $537.03 | $1,659.59 | $4,897.79 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $446.68 | Professional | None | $186.21 | $281.84 | $446.68 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $269.15 Typical High $1,584.89 | Facility | None | $239.88 | $269.15 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $407.38 | Professional | None | $199.53 | $269.15 | $407.38 |
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 $147.91 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $58.88 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $223.87 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $257.04 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $239.88 | $323.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $81.28 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $40.74 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $208.93 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $154.88 | $194.98 | $269.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $239.88 | $323.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $120.23 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $120.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $60.26 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $60.26 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $208.93 | $281.84 |
Where New York sits
The same service costs 5.2 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· 42nd of 51
$295
AK $1,000UT $191
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.