How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,380 to $11,749Professionalmedian $977 · 10th to 90th $776 to $2,089
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 $14,454.40 | Facility | None | $1,819.70 | $6,309.57 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $3,235.94 | Professional | None | $977.24 | $977.24 | $3,235.94 |
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 $831.76 Median $977.24 Typical High $1,905.46 | Professional | None | $831.76 | $977.24 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $2,818.38 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $2,818.38 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,232.93 | Facility | None | $1,737.80 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $3,890.45 | Professional | None | $776.25 | $1,071.52 | $3,890.45 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $3,715.35 | Facility | None | $1,071.52 | $1,905.46 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,862.09 | Professional | None | $977.24 | $1,122.02 | $1,862.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,288.25 | Professional | None | $691.83 | $870.96 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $1,096.48 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,096.48 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,348.96 | $2,570.40 |
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 $575.44 Median $1,047.13 Typical High $2,884.03 | Professional | None | $575.44 | $1,047.13 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $794.33 Median $933.25 Typical High $5,495.41 | Facility | None | $794.33 | $933.25 | $5,495.41 |
Univera Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,202.26 | Professional | None | $691.83 | $870.96 | $1,202.26 |
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 $489.78 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $1,174.90 | Professional | 54 · Surgery only | $588.84 | $741.31 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $120.23 Typical High $190.55 | Professional | 55 · Aftercare only | $97.72 | $120.23 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $95.50 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $95.50 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $1,071.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $691.83 Typical High $1,047.13 | Professional | 53 · Discontinued | $524.81 | $691.83 | $1,047.13 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $1,096.48 | Professional | 54 · Surgery only | $588.84 | $741.31 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $281.84 | Professional | 55 · Aftercare only | $97.72 | $123.03 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $61.66 Typical High $141.25 | Professional | 56 · Pre-op care only | $48.98 | $61.66 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $1,023.29 |
Where New York sits
The same service costs 3.6 times more in Alaska than in Montana. 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 $11,248MT $3,134
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.