How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,148 to $15,488Professionalmedian $1,072 · 10th to 90th $891 to $1,549
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 $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS 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 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $4,570.88 | Facility | None | $1,258.93 | $1,479.11 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,380.38 | $2,454.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,445.44 | Professional | None | $933.25 | $1,096.48 | $1,445.44 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,584.89 | Professional | None | $954.99 | $954.99 | $1,584.89 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,621.81 | Professional | None | $851.14 | $1,023.29 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,148.15 | $1,318.26 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,445.44 | Professional | None | $831.76 | $1,096.48 | $1,445.44 |
16 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 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $97.72 Typical High $128.82 | Professional | 56 · Pre-op care only | $83.18 | $97.72 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $758.58 | $891.25 | $1,174.90 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Facility | 54 · Surgery only | $1,023.29 | $1,174.90 | $1,174.90 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $131.83 | Facility | 55 · Aftercare only | $114.82 | $131.83 | $131.83 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $117.49 | Facility | 56 · Pre-op care only | $102.33 | $117.49 | $117.49 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,071.52 Typical High $1,071.52 | Facility | 78 · Unplanned return to OR | $933.25 | $1,071.52 | $1,071.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $741.31 | $977.24 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $83.18 | $109.65 | $144.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $97.72 Typical High $128.82 | Professional | 56 · Pre-op care only | $74.13 | $97.72 | $128.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $660.69 | $891.25 | $1,174.90 |
Where New York sits
The same service costs 16.2 times more in Alaska than in Texas. 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· 43rd of 51
$1,072
AK $3,090TX $191
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.