How much rates vary
Facilitymedian $2,512 · 10th to 90th $224 to $5,012Professionalmedian $135 · 10th to 90th $85 to $288
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 $138.04 Median $3,801.89 Typical High $8,128.31 | Facility | None | $138.04 | $3,801.89 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $257.04 | Professional | None | $81.28 | $138.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $309.03 | Professional | None | $107.15 | $128.82 | $309.03 |
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 $131.83 Median $131.83 Typical High $245.47 | Professional | None | $131.83 | $131.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $190.55 Typical High $389.05 | Facility | None | $100.00 | $190.55 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $309.03 | Professional | None | $77.62 | $138.04 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $109.65 Median $162.18 Typical High $371.54 | Facility | None | $109.65 | $162.18 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $416.87 | Professional | None | $229.09 | $251.19 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $204.17 | Professional | None | $114.82 | $173.78 | $204.17 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $3,235.94 Typical High $4,365.16 | Facility | None | $181.97 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $398.11 | Professional | None | $229.09 | $229.09 | $398.11 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $66.07 Median $128.82 Typical High $269.15 | Professional | None | $66.07 | $128.82 | $269.15 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $158.49 Typical High $724.44 | Facility | None | $67.61 | $158.49 | $724.44 |
Univera Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $204.17 | Professional | None | $114.82 | $173.78 | $204.17 |
14 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 $39.81 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $39.81 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $16.22 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.13 | $13.80 | $15.85 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $186.21 | $245.47 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $30.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $30.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $245.47 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $87.10 | $107.15 | $128.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $186.21 | $245.47 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $158.49 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $158.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $158.49 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $245.47 |
Where New York sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.