How much rates vary
Facilitymedian $2,692 · 10th to 90th $219 to $5,012Professionalmedian $44 · 10th to 90th $33 to $83
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 $4,168.69 Typical High $10,232.93 | Facility | None | $645.65 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $58.88 | Professional | None | $41.69 | $43.65 | $58.88 |
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 $35.48 Median $41.69 Typical High $87.10 | Professional | None | $35.48 | $41.69 | $87.10 |
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 $69.18 Median $69.18 Typical High $74.13 | Professional | None | $69.18 | $69.18 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $1,096.48 | Facility | None | $74.13 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $60.26 Typical High $87.10 | Professional | None | $30.20 | $60.26 | $87.10 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $52.48 Typical High $162.18 | Facility | None | $34.67 | $52.48 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $6.17 Median $48.98 Typical High $56.23 | Professional | None | $6.17 | $48.98 | $56.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $35.48 Median $43.65 Typical High $64.57 | Professional | None | $35.48 | $43.65 | $64.57 |
MVP Health Care Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
MVP Health Care Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $97.72 | Professional | None | $38.90 | $38.90 | $97.72 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $4,365.16 | Facility | None | $309.03 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $28.84 Median $47.86 Typical High $85.11 | Professional | None | $28.84 | $47.86 | $85.11 |
Univera Setting Facility Modifier None Typical Low $36.31 Median $46.77 Typical High $144.54 | Facility | None | $36.31 | $46.77 | $144.54 |
Univera Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $64.57 | Professional | None | $35.48 | $46.77 | $64.57 |
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 $20.89 Median $21.88 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $10.00 | Professional | 53 · Discontinued | $8.32 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $32.36 Typical High $37.15 | Professional | 54 · Surgery only | $31.62 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.37 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.17 | $4.37 | $5.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $30.90 Typical High $34.67 | Professional | 78 · Unplanned return to OR | $29.51 | $30.90 | $34.67 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $45.71 Typical High $57.54 | Professional | 54 · Surgery only | $32.36 | $45.71 | $57.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.13 Typical High $6.46 | Professional | 55 · Aftercare only | $3.55 | $5.13 | $6.46 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.13 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.55 | $5.13 | $6.46 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $40.74 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $28.84 | $40.74 | $51.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $33.88 | $38.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $45.71 Typical High $57.54 | Professional | 54 · Surgery only | $32.36 | $45.71 | $57.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.13 Typical High $6.92 | Professional | 55 · Aftercare only | $3.55 | $5.13 | $6.92 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.13 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.55 | $5.13 | $6.92 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $40.74 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $28.84 | $40.74 | $51.29 |
Where New York sits
The same service costs 4.6 times more in Alaska than in New York. 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· 51st of 51
$43.65
AK $200NY $43.65
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.