How much rates vary
Facilitymedian $2,630 · 10th to 90th $257 to $5,129Professionalmedian $178 · 10th to 90th $123 to $331
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 $1,000.00 Median $3,981.07 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,981.07 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $338.84 | Professional | None | $125.89 | $173.78 | $338.84 |
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 $154.88 Median $186.21 Typical High $354.81 | Professional | None | $154.88 | $186.21 | $354.81 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $288.40 | Professional | None | $190.55 | $190.55 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $389.05 | Facility | None | $100.00 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $338.84 | Professional | None | $83.18 | $173.78 | $338.84 |
Emblem Health Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $467.74 | Facility | None | $128.82 | $144.54 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $407.38 | Professional | None | $218.78 | $239.88 | $407.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $239.88 | Professional | None | $138.04 | $165.96 | $239.88 |
Highmark BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | None | $190.55 | $229.09 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $218.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $218.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $371.54 | Professional | None | $165.96 | $165.96 | $371.54 |
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 $85.11 Median $154.88 Typical High $316.23 | Professional | None | $85.11 | $154.88 | $316.23 |
Univera Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $794.33 | Facility | None | $102.33 | $186.21 | $794.33 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $239.88 | Professional | None | $138.04 | $186.21 | $239.88 |
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 $63.10 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $131.83 Typical High $141.25 | Professional | 54 · Surgery only | $93.33 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $123.03 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $87.10 | $123.03 | $131.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $173.78 Typical High $213.80 | Professional | 54 · Surgery only | $125.89 | $173.78 | $213.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $23.99 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $23.99 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $109.65 | $154.88 | $190.55 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $131.83 | $151.36 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $173.78 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $173.78 | $223.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $26.92 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $26.92 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $154.88 | $199.53 |
Where New York sits
The same service costs 3.5 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
$186
AK $550MD $155
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.