How much rates vary
Facilitymedian $2,818 · 10th to 90th $617 to $6,166Professionalmedian $513 · 10th to 90th $407 to $813
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 $1,698.24 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,698.24 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $831.76 | Professional | None | $588.84 | $616.60 | $831.76 |
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 $426.58 Median $512.86 Typical High $707.95 | Professional | None | $426.58 | $512.86 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $758.58 Typical High $1,047.13 | Professional | 50 · Both sides | $645.65 | $758.58 | $1,047.13 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $1,479.11 | Facility | None | $407.38 | $676.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $1,096.48 | Professional | None | $398.11 | $416.87 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $1,778.28 | Facility | None | $489.78 | $660.69 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $660.69 Typical High $660.69 | Professional | None | $162.18 | $660.69 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $660.69 | Professional | None | $354.81 | $446.68 | $660.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $630.96 | Professional | None | $478.63 | $602.56 | $630.96 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $4,365.16 | Facility | None | $616.60 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | None | $630.96 | $812.83 | $812.83 |
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 $363.08 Median $512.86 Typical High $794.33 | Professional | None | $363.08 | $512.86 | $794.33 |
Univera Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $2,187.76 | Facility | None | $457.09 | $478.63 | $2,187.76 |
Univera Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $660.69 | Professional | None | $354.81 | $457.09 | $660.69 |
16 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 $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $426.58 | $467.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $331.13 | $398.11 | $537.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $66.07 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $467.74 |
Fidelis Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $407.38 Median $501.19 Typical High $691.83 | Professional | 79 · Unrelated procedure after surgery | $407.38 | $501.19 | $691.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $331.13 Typical High $446.68 | Professional | 53 · Discontinued | $263.03 | $331.13 | $446.68 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $331.13 | $398.11 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $218.78 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $109.65 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $109.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $467.74 |
Where New York sits
The same service costs 6.2 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· 46th of 51
$525
AK $1,995UT $324
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.