How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,148 to $10,471Professionalmedian $457 · 10th to 90th $380 to $692
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | None | $588.84 | $588.84 | $676.08 |
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 $389.05 Median $457.09 Typical High $660.69 | Professional | None | $389.05 | $457.09 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $691.83 Typical High $977.24 | Professional | 50 · Both sides | $588.84 | $691.83 | $977.24 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,715.35 Typical High $7,244.36 | Facility | None | $1,148.15 | $3,715.35 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $1,096.48 | Professional | None | $389.05 | $416.87 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $575.44 Typical High $1,778.28 | Facility | None | $467.74 | $575.44 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $794.33 | Professional | None | $436.52 | $512.86 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $660.69 | Professional | None | $251.19 | $416.87 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $446.68 Median $3,235.94 Typical High $4,365.16 | Facility | None | $446.68 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | None | $602.56 | $602.56 | $691.83 |
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 $331.13 Median $501.19 Typical High $758.58 | Professional | None | $331.13 | $501.19 | $758.58 |
Univera Setting Facility Modifier None Typical Low $436.52 Median $478.63 Typical High $1,737.80 | Facility | None | $436.52 | $478.63 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $660.69 | Professional | None | $251.19 | $416.87 | $660.69 |
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 $295.12 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $467.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $524.81 | Professional | 54 · Surgery only | $281.84 | $331.13 | $524.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $131.83 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $66.07 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $288.40 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $245.47 | $288.40 | $457.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $316.23 Typical High $436.52 | Professional | 53 · Discontinued | $251.19 | $316.23 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $524.81 | Professional | 54 · Surgery only | $281.84 | $346.74 | $524.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $194.98 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $97.72 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $97.72 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $457.09 |
Where New York sits
The same service costs 7.9 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
$479
WY $2,344UT $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.