How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,072 to $8,128Professionalmedian $676 · 10th to 90th $537 to $1,000
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | None | $870.96 | $870.96 | $1,023.29 |
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 $575.44 Median $676.08 Typical High $741.31 | Professional | None | $575.44 | $676.08 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,023.29 Typical High $1,122.02 | Professional | 50 · Both sides | $851.14 | $1,023.29 | $1,122.02 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,677.35 Typical High $13,803.84 | Facility | None | $3,388.44 | $4,677.35 | $13,803.84 |
CDPHP Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $4,265.80 | Facility | None | $1,513.56 | $2,454.71 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,819.70 | Professional | None | $660.69 | $676.08 | $1,819.70 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $2,884.03 | Facility | None | $645.65 | $933.25 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | None | $446.68 | $660.69 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,000.00 | Professional | None | $436.52 | $616.60 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $954.99 Median $4,786.30 Typical High $5,754.40 | Facility | None | $954.99 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,398.83 Typical High $7,244.36 | Facility | None | $1,096.48 | $2,398.83 | $7,244.36 |
United Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,071.52 | Professional | None | $524.81 | $691.83 | $1,071.52 |
Univera Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $3,548.13 | Facility | None | $446.68 | $724.44 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,000.00 | Professional | None | $436.52 | $616.60 | $1,000.00 |
14 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 $436.52 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 54 · Surgery only | $426.58 | $501.19 | $794.33 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $199.53 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $100.00 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $100.00 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 54 · Surgery only | $426.58 | $501.19 | $794.33 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $131.83 Typical High $295.12 | Professional | 55 · Aftercare only | $104.71 | $131.83 | $295.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $147.91 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $147.91 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $707.95 |
Where New York sits
The same service costs 4.6 times more in Alaska than in New York. 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· 51st of 51
$676
AK $3,090NY $676
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.