How much rates vary
Facilitymedian $2,754 · 10th to 90th $646 to $5,248Professionalmedian $525 · 10th to 90th $417 to $891
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 $1,230.27 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,230.27 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $933.25 | Professional | None | $588.84 | $630.96 | $933.25 |
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 $446.68 Median $524.81 Typical High $741.31 | Professional | None | $446.68 | $524.81 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $776.25 Typical High $1,096.48 | Professional | 50 · Both sides | $660.69 | $776.25 | $1,096.48 |
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 $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $691.83 Typical High $1,479.11 | Facility | None | $416.87 | $691.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $1,096.48 | Professional | None | $398.11 | $426.58 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $977.24 Typical High $1,905.46 | Facility | None | $489.78 | $977.24 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $977.24 | Professional | None | $549.54 | $630.96 | $977.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $691.83 | Professional | None | $426.58 | $512.86 | $691.83 |
MVP Health Care Setting Facility Modifier None Typical Low $933.25 Median $3,235.94 Typical High $4,365.16 | Facility | None | $933.25 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $891.25 | Professional | None | $645.65 | $891.25 | $891.25 |
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 $371.54 Median $512.86 Typical High $912.01 | Professional | None | $371.54 | $512.86 | $912.01 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $549.54 Typical High $2,818.38 | Facility | None | $478.63 | $549.54 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $691.83 | Professional | None | $426.58 | $512.86 | $691.83 |
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 $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $338.84 | $407.38 | $549.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $138.04 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $138.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $69.18 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $69.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $478.63 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $467.74 | Professional | 53 · Discontinued | $269.15 | $338.84 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $338.84 | $407.38 | $549.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $223.87 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $112.20 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $112.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $549.54 |
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· 44th of 51
$537
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.