How much rates vary
Facilitymedian $2,692 · 10th to 90th $363 to $5,012Professionalmedian $191 · 10th to 90th $110 to $380
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 $645.65 Median $5,888.44 Typical High $10,964.78 | Facility | None | $645.65 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $213.80 | Professional | None | $117.49 | $208.93 | $213.80 |
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 $162.18 Median $194.98 Typical High $416.87 | Professional | None | $162.18 | $194.98 | $416.87 |
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 $186.21 Median $186.21 Typical High $338.84 | Professional | None | $186.21 | $186.21 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $1,096.48 | Facility | None | $100.00 | $154.88 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $169.82 Typical High $398.11 | Professional | None | $81.28 | $169.82 | $398.11 |
Emblem Health Setting Facility Modifier None Typical Low $45.71 Median $138.04 Typical High $457.09 | Facility | None | $45.71 | $138.04 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $467.74 | Professional | None | $251.19 | $275.42 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $275.42 | Professional | None | $151.36 | $190.55 | $275.42 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $3,235.94 Typical High $4,365.16 | Facility | None | $138.04 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $389.05 | Professional | None | $109.65 | $109.65 | $389.05 |
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 $87.10 Median $165.96 Typical High $346.74 | Professional | None | $87.10 | $165.96 | $346.74 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $426.58 | Facility | None | $100.00 | $208.93 | $426.58 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $275.42 | Professional | None | $151.36 | $208.93 | $275.42 |
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 $57.54 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $23.44 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $154.88 Typical High $158.49 | Professional | 54 · Surgery only | $87.10 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $30.90 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.75 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $144.54 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $81.28 | $144.54 | $147.91 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $194.98 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $194.98 | $245.47 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $27.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $27.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $173.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $173.78 | $218.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $125.89 | $147.91 | $177.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $194.98 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $194.98 | $245.47 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $15.14 | $22.39 | $30.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.14 | $22.39 | $30.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $177.83 | $218.78 |
Where New York sits
The same service costs 3.8 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· 43rd of 51
$195
AK $603MD $158
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.