How much rates vary
Facilitymedian $2,692 · 10th to 90th $398 to $5,012Professionalmedian $347 · 10th to 90th $204 to $692
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 $912.01 Median $5,888.44 Typical High $10,964.78 | Facility | None | $912.01 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $398.11 | Professional | None | $213.80 | $354.81 | $398.11 |
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 $302.00 Median $363.08 Typical High $724.44 | Professional | None | $302.00 | $363.08 | $724.44 |
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 $309.03 Median $309.03 Typical High $588.84 | Professional | None | $309.03 | $309.03 | $588.84 |
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 $131.83 Median $302.00 Typical High $724.44 | Professional | None | $131.83 | $302.00 | $724.44 |
Emblem Health Setting Facility Modifier None Typical Low $165.96 Median $239.88 Typical High $758.58 | Facility | None | $165.96 | $239.88 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $776.25 | Professional | None | $416.87 | $457.09 | $776.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $446.68 | Professional | None | $257.04 | $346.74 | $446.68 |
MVP Health Care Setting Facility Modifier None Typical Low $239.88 Median $3,235.94 Typical High $4,365.16 | Facility | None | $239.88 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $588.84 | Professional | None | $204.17 | $204.17 | $588.84 |
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 $141.25 Median $288.40 Typical High $602.56 | Professional | None | $141.25 | $288.40 | $602.56 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $707.95 | Facility | None | $162.18 | $354.81 | $707.95 |
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 $107.15 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $107.15 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $70.79 Typical High $79.43 | Professional | 53 · Discontinued | $42.66 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $21.38 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $251.19 | $275.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $208.93 | $295.12 | $363.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $69.18 Typical High $85.11 | Professional | 55 · Aftercare only | $48.98 | $69.18 | $85.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $316.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $223.87 | $269.15 | $323.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $208.93 | $295.12 | $363.08 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $69.18 Typical High $95.50 | Professional | 55 · Aftercare only | $48.98 | $69.18 | $95.50 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $50.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $354.81 |
Where New York sits
The same service costs 4.6 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· 30th of 51
$363
AK $1,000TX $219
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.