How much rates vary
Facilitymedian $3,090 · 10th to 90th $407 to $7,244Professionalmedian $170 · 10th to 90th $105 to $316
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 $1,348.96 Median $4,265.80 Typical High $8,317.64 | Facility | None | $1,348.96 | $4,265.80 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $208.93 | Professional | None | $104.71 | $165.96 | $208.93 |
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 $147.91 Median $177.83 Typical High $323.59 | Professional | None | $147.91 | $177.83 | $323.59 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $288.40 | Professional | None | $173.78 | $173.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $1,479.11 | Facility | None | $190.55 | $354.81 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $331.13 | Professional | None | $75.86 | $151.36 | $331.13 |
Emblem Health Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $426.58 | Facility | None | $95.50 | $131.83 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $154.88 Typical High $213.80 | Professional | None | $40.74 | $154.88 | $213.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $229.09 | Professional | None | $131.83 | $162.18 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Highmark BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $346.74 | Professional | None | $144.54 | $144.54 | $346.74 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $288.40 | Professional | None | $77.62 | $144.54 | $288.40 |
Univera Setting Facility Modifier None Typical Low $91.20 Median $181.97 Typical High $354.81 | Facility | None | $91.20 | $181.97 | $354.81 |
Univera Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $229.09 | Professional | None | $131.83 | $181.97 | $229.09 |
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 $52.48 Median $83.18 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.11 Typical High $36.31 | Professional | 53 · Discontinued | $20.89 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $125.89 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $26.92 | Professional | 55 · Aftercare only | $15.85 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.60 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.47 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $117.49 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $72.44 | $117.49 | $125.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $169.82 | $204.17 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $13.18 | $19.05 | $22.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.18 | $19.05 | $22.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $151.36 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $104.71 | $151.36 | $181.97 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $128.82 | $147.91 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $169.82 | $213.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $13.18 | $19.05 | $25.70 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.18 | $19.05 | $25.70 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $104.71 | $151.36 | $190.55 |
Where New York sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 41st of 51
$174
AK $501KY $138
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.