How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,047 to $7,943Professionalmedian $646 · 10th to 90th $513 to $977
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 $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
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 $549.54 Median $645.65 Typical High $933.25 | Professional | None | $549.54 | $645.65 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $977.24 Typical High $1,412.54 | Professional | 50 · Both sides | $812.83 | $977.24 | $1,412.54 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,348.96 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,584.89 | Professional | None | $562.34 | $588.84 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $758.58 Typical High $2,511.89 | Facility | None | $645.65 | $758.58 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $630.96 Typical High $630.96 | Professional | None | $123.03 | $630.96 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $933.25 | Professional | None | $363.08 | $588.84 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $4,786.30 Typical High $5,754.40 | Facility | None | $660.69 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
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 $467.74 Median $707.95 Typical High $1,096.48 | Professional | None | $467.74 | $707.95 | $1,096.48 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $676.08 Typical High $2,238.72 | Facility | None | $616.60 | $676.08 | $2,238.72 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $933.25 | Professional | None | $363.08 | $588.84 | $933.25 |
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 $426.58 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $467.74 Typical High $741.31 | Professional | 54 · Surgery only | $398.11 | $467.74 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $186.21 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $93.33 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $407.38 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $346.74 | $407.38 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $446.68 Typical High $616.60 | Professional | 53 · Discontinued | $354.81 | $446.68 | $616.60 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $489.78 Typical High $741.31 | Professional | 54 · Surgery only | $398.11 | $489.78 | $741.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $275.42 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $61.66 Typical High $138.04 | Professional | 56 · Pre-op care only | $48.98 | $61.66 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $426.58 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $346.74 | $426.58 | $645.65 |
Where New York sits
The same service costs 4.0 times more in Alaska than in Alabama. 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.
Physician feeFacility fee
AK $6,054AL $1,518
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.