How much rates vary
Facilitymedian $3,311 · 10th to 90th $676 to $7,586Professionalmedian $316 · 10th to 90th $234 to $513
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $446.68 | Professional | None | $281.84 | $363.08 | $446.68 |
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 $281.84 Median $331.13 Typical High $512.86 | Professional | None | $281.84 | $331.13 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $501.19 Typical High $758.58 | Professional | 50 · Both sides | $426.58 | $501.19 | $758.58 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $537.03 | Professional | None | $331.13 | $331.13 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $2,187.76 | Facility | None | $338.84 | $630.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $602.56 | Professional | None | $186.21 | $302.00 | $602.56 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $309.03 Typical High $812.83 | Facility | None | $223.87 | $309.03 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $676.08 | Professional | None | $331.13 | $446.68 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $478.63 | Professional | None | $204.17 | $331.13 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $229.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $229.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $512.86 | Professional | None | $269.15 | $269.15 | $512.86 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $489.78 | Professional | None | $177.83 | $309.03 | $489.78 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $794.33 | Facility | None | $223.87 | $331.13 | $794.33 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $478.63 | Professional | None | $204.17 | $331.13 | $478.63 |
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 $141.25 Median $177.83 Typical High $223.87 | Professional | 52 · Reduced service | $141.25 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $56.23 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $213.80 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $35.48 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.18 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $245.47 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $199.53 | $245.47 | $316.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $436.52 | Professional | 54 · Surgery only | $269.15 | $323.59 | $436.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $35.48 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $35.48 | $47.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $47.86 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $47.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $239.88 | $288.40 | $389.05 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | 53 · Discontinued | $186.21 | $223.87 | $316.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $436.52 | Professional | 54 · Surgery only | $269.15 | $323.59 | $436.52 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $35.48 Typical High $70.79 | Professional | 55 · Aftercare only | $29.51 | $35.48 | $70.79 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $70.79 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $239.88 | $288.40 | $389.05 |
Where New York sits
The same service costs 3.9 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· 42nd of 51
$331
WY $1,096UT $282
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.