How much rates vary
Facilitymedian $2,570 · 10th to 90th $427 to $4,898Professionalmedian $380 · 10th to 90th $263 to $759
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 $1,071.52 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,071.52 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $457.09 | Professional | None | $316.23 | $398.11 | $457.09 |
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 $316.23 Median $380.19 Typical High $794.33 | Professional | None | $316.23 | $380.19 | $794.33 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $645.65 | Professional | None | $501.19 | $501.19 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $537.03 Typical High $1,479.11 | Facility | None | $309.03 | $537.03 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $446.68 Typical High $758.58 | Professional | None | $213.80 | $446.68 | $758.58 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $371.54 Typical High $1,202.26 | Facility | None | $275.42 | $371.54 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $891.25 | Professional | None | $524.81 | $524.81 | $891.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $549.54 | Professional | None | $302.00 | $371.54 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $776.25 | Professional | None | $263.03 | $263.03 | $776.25 |
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 $223.87 Median $371.54 Typical High $741.31 | Professional | None | $223.87 | $371.54 | $741.31 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $338.84 Typical High $724.44 | Facility | None | $263.03 | $338.84 | $724.44 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $549.54 | Professional | None | $302.00 | $371.54 | $549.54 |
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 $154.88 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $154.88 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $234.42 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $61.66 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $218.78 | $281.84 | $288.40 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $245.47 | $338.84 | $446.68 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $57.54 | $81.28 | $104.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $54.95 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $54.95 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $218.78 | $302.00 | $389.05 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $239.88 | $302.00 | $338.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $245.47 | $338.84 | $446.68 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $57.54 | $81.28 | $112.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $60.26 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $218.78 | $302.00 | $389.05 |
Where New York sits
The same service costs 6.0 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· 40th of 51
$398
AK $1,445TX $240
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.