How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $10,233Professionalmedian $479 · 10th to 90th $380 to $708
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 $602.56 Median $602.56 Typical High $676.08 | Professional | None | $602.56 | $602.56 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $660.69 | Professional | None | $398.11 | $467.74 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $691.83 Typical High $1,000.00 | Professional | 50 · Both sides | $588.84 | $691.83 | $1,000.00 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $1,122.02 | Professional | None | $398.11 | $416.87 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $1,778.28 | Facility | None | $489.78 | $616.60 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $776.25 | Professional | None | $436.52 | $501.19 | $776.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $660.69 | Professional | None | $323.59 | $416.87 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $3,235.94 Typical High $4,365.16 | Facility | None | $691.83 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | None | $616.60 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,202.26 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $776.25 | Professional | None | $338.84 | $501.19 | $776.25 |
Univera Setting Facility Modifier None Typical Low $436.52 Median $478.63 Typical High $2,511.89 | Facility | None | $436.52 | $478.63 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $660.69 | Professional | None | $323.59 | $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 $302.00 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $478.63 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $537.03 | Professional | 54 · Surgery only | $281.84 | $331.13 | $537.03 |
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 $467.74 | Professional | 78 · Unplanned return to OR | $245.47 | $288.40 | $467.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $446.68 | Professional | 53 · Discontinued | $257.04 | $316.23 | $446.68 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $537.03 | Professional | 54 · Surgery only | $281.84 | $346.74 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $194.98 | Professional | 55 · Aftercare only | $70.79 | $87.10 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $97.72 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $97.72 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $467.74 |
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· 47th of 51
$490
WY $2,399UT $302
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.