How much rates vary
Facilitymedian $2,692 · 10th to 90th $437 to $5,012Professionalmedian $389 · 10th to 90th $263 to $794
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 $1,122.02 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,122.02 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $630.96 | Professional | None | $316.23 | $426.58 | $630.96 |
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 $323.59 Median $389.05 Typical High $831.76 | Professional | None | $323.59 | $389.05 | $831.76 |
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 $489.78 Median $489.78 Typical High $676.08 | Professional | None | $489.78 | $489.78 | $676.08 |
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 $218.78 Median $446.68 Typical High $794.33 | Professional | None | $218.78 | $446.68 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $1,230.27 | Facility | None | $257.04 | $389.05 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $954.99 | Professional | None | $512.86 | $562.34 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $575.44 | Professional | None | $323.59 | $389.05 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $354.81 Median $3,235.94 Typical High $4,365.16 | Facility | None | $354.81 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $691.83 | Professional | None | $213.80 | $213.80 | $691.83 |
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 $389.05 Typical High $758.58 | Professional | None | $223.87 | $389.05 | $758.58 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $977.24 | Facility | None | $263.03 | $426.58 | $977.24 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $575.44 | Professional | None | $323.59 | $426.58 | $575.44 |
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 $158.49 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $158.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $239.88 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $302.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $363.08 Typical High $467.74 | Professional | 54 · Surgery only | $257.04 | $363.08 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $109.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $57.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $309.03 Typical High $363.08 | Professional | 53 · Discontinued | $245.47 | $309.03 | $363.08 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $363.08 Typical High $467.74 | Professional | 54 · Surgery only | $257.04 | $363.08 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $117.49 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $117.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $63.10 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $426.58 |
Where New York sits
The same service costs 4.7 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
$407
AK $1,445TX $309
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.