How much rates vary
Facilitymedian $2,570 · 10th to 90th $372 to $5,248Professionalmedian $316 · 10th to 90th $214 to $646
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 $331.13 Median $3,890.45 Typical High $8,128.31 | Facility | None | $331.13 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $645.65 | Professional | None | $218.78 | $331.13 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $741.31 | Professional | None | $363.08 | $363.08 | $741.31 |
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 $251.19 Median $316.23 Typical High $707.95 | Professional | None | $251.19 | $316.23 | $707.95 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $562.34 | Professional | None | $338.84 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $588.84 Typical High $1,737.80 | Facility | None | $309.03 | $588.84 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $691.83 | Professional | None | $186.21 | $331.13 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $831.76 | Facility | None | $199.53 | $245.47 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $870.96 | Professional | None | $416.87 | $457.09 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $446.68 | Professional | None | $257.04 | $354.81 | $446.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $125.89 Median $630.96 Typical High $812.83 | Facility | None | $125.89 | $630.96 | $812.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $467.74 | Professional | None | $354.81 | $354.81 | $467.74 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $3,235.94 Typical High $4,365.16 | Facility | None | $275.42 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $660.69 | Professional | None | $213.80 | $213.80 | $660.69 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $562.34 | Professional | None | $151.36 | $281.84 | $562.34 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $912.01 | Facility | None | $177.83 | $354.81 | $912.01 |
Univera Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $446.68 | Professional | None | $257.04 | $354.81 | $446.68 |
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 $109.65 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $109.65 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $43.65 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $162.18 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $32.36 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $21.88 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $151.36 | $229.09 | $251.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $331.13 | $407.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $44.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $37.15 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $208.93 | $295.12 | $354.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $251.19 | $288.40 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $331.13 | $407.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $50.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $37.15 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.70 | $37.15 | $50.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $208.93 | $295.12 | $354.81 |
Where New York sits
The same service costs 3.5 times more in Alaska 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.
New York· 46th of 51
$316
AK $977MD $282
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.