How much rates vary
Facilitymedian $2,754 · 10th to 90th $363 to $5,248Professionalmedian $166 · 10th to 90th $110 to $316
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 $4,168.69 Typical High $8,317.64 | Facility | None | $1,122.02 | $4,168.69 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $316.23 | Professional | None | $112.20 | $162.18 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $147.91 Median $177.83 Typical High $331.13 | Professional | None | $147.91 | $177.83 | $331.13 |
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 $169.82 Median $169.82 Typical High $275.42 | Professional | None | $169.82 | $169.82 | $275.42 |
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 $74.13 Median $154.88 Typical High $316.23 | Professional | None | $74.13 | $154.88 | $316.23 |
Emblem Health Setting Facility Modifier None Typical Low $112.20 Median $128.82 Typical High $426.58 | Facility | None | $112.20 | $128.82 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $380.19 | Professional | None | $204.17 | $223.87 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | None | $128.82 | $173.78 | $234.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $602.56 | Facility | None | $281.84 | $281.84 | $602.56 |
Highmark BCBS Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $229.09 | Professional | None | $151.36 | $213.80 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $123.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $123.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $346.74 | Professional | None | $154.88 | $154.88 | $346.74 |
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 $77.62 Median $141.25 Typical High $281.84 | Professional | None | $77.62 | $141.25 | $281.84 |
Univera Setting Facility Modifier None Typical Low $91.20 Median $173.78 Typical High $489.78 | Facility | None | $91.20 | $173.78 | $489.78 |
Univera Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | None | $128.82 | $173.78 | $234.42 |
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 $56.23 Median $81.28 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.11 Typical High $35.48 | Professional | 53 · Discontinued | $22.39 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $131.83 | Professional | 54 · Surgery only | $83.18 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $26.30 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $114.82 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $77.62 | $114.82 | $123.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $162.18 | $208.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $12.88 | $18.20 | $23.44 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $23.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $104.71 | $144.54 | $186.21 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $123.03 | $141.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $162.18 | $208.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $18.20 Typical High $25.12 | Professional | 55 · Aftercare only | $12.88 | $18.20 | $25.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $25.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $104.71 | $144.54 | $186.21 |
Where New York sits
The same service costs 3.3 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· 39th of 51
$174
AK $490MD $148
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.