How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,230 to $10,715Professionalmedian $794 · 10th to 90th $646 to $1,230
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 $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,047.13 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,148.15 | Professional | None | $676.08 | $794.33 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,737.80 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,737.80 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,715.35 Typical High $7,244.36 | Facility | None | $1,348.96 | $3,715.35 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,949.84 | Professional | None | $691.83 | $724.44 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $3,162.28 | Facility | None | $794.33 | $954.99 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,380.38 | Professional | None | $758.58 | $891.25 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $1,122.02 | Professional | None | $436.52 | $741.31 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $794.33 Median $4,786.30 Typical High $5,754.40 | Facility | None | $794.33 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,230.27 | Professional | None | $977.24 | $977.24 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,754.23 | $7,943.28 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,348.96 | Professional | None | $588.84 | $870.96 | $1,348.96 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $831.76 Typical High $3,090.30 | Facility | None | $758.58 | $831.76 | $3,090.30 |
Univera Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $1,122.02 | Professional | None | $436.52 | $741.31 | $1,122.02 |
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 $588.84 | Professional | 52 · Reduced service | $524.81 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $831.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $912.01 | Professional | 54 · Surgery only | $501.19 | $588.84 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $229.09 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $61.66 | $74.13 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $549.54 Typical High $776.25 | Professional | 53 · Discontinued | $436.52 | $549.54 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $912.01 | Professional | 54 · Surgery only | $501.19 | $602.56 | $912.01 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $371.54 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $186.21 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $794.33 |
Where New York sits
The same service costs 7.6 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· 45th of 51
$851
AK $3,548UT $468
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.