How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,288 to $10,000Professionalmedian $912 · 10th to 90th $759 to $1,445
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
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 $758.58 Median $891.25 Typical High $1,380.38 | Professional | None | $758.58 | $891.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $2,089.30 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $2,089.30 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,584.89 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $2,290.87 | Professional | None | $851.14 | $891.25 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $3,548.13 | Facility | None | $602.56 | $1,071.52 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,380.38 | Professional | None | $501.19 | $891.25 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,548.82 | Professional | None | $707.95 | $1,000.00 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $3,630.78 | Facility | None | $933.25 | $1,000.00 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,380.38 | Professional | None | $501.19 | $891.25 | $1,380.38 |
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 $575.44 Median $575.44 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $229.09 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $1,096.48 | Professional | 54 · Surgery only | $602.56 | $707.95 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $275.42 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $275.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $138.04 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $954.99 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $630.96 Typical High $933.25 | Professional | 53 · Discontinued | $512.86 | $630.96 | $933.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $602.56 | $724.44 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $181.97 Typical High $446.68 | Professional | 55 · Aftercare only | $151.36 | $181.97 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $223.87 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $954.99 |
Where New York sits
The same service costs 7.2 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· 47th of 51
$933
AK $4,266UT $589
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.