How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,479 to $11,749Professionalmedian $1,230 · 10th to 90th $955 to $2,818
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 $6,309.57 Typical High $13,182.57 | Facility | None | $1,819.70 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,288.25 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,174.90 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,778.28 Typical High $3,890.45 | Professional | 50 · Both sides | $1,513.56 | $1,778.28 | $3,890.45 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $4,897.79 Typical High $10,232.93 | Facility | None | $2,041.74 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $5,248.07 | Professional | None | $1,096.48 | $1,445.44 | $5,248.07 |
Emblem Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $5,011.87 | Facility | None | $1,380.38 | $2,137.96 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,584.89 | $2,630.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,737.80 | Professional | None | $933.25 | $1,230.27 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,479.11 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,479.11 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,513.56 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,412.54 Typical High $3,801.89 | Professional | None | $776.25 | $1,412.54 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $4,786.30 | Facility | None | $1,096.48 | $1,318.26 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $933.25 | $1,230.27 | $1,698.24 |
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 $645.65 Median $645.65 Typical High $870.96 | Professional | 52 · Reduced service | $645.65 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $346.74 | Professional | 53 · Discontinued | $257.04 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,584.89 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | 55 · Aftercare only | $131.83 | $173.78 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $128.82 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $741.31 | $977.24 | $1,445.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $912.01 Typical High $1,412.54 | Professional | 53 · Discontinued | $691.83 | $912.01 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,513.56 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $173.78 Typical High $380.19 | Professional | 55 · Aftercare only | $131.83 | $173.78 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $977.24 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $741.31 | $977.24 | $1,380.38 |
Where New York sits
The same service costs 3.0 times more in Alaska than in Vermont. 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.
Physician feeFacility fee
AK $12,999VT $4,294
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.