How much rates vary
Facilitymedian $3,090 · 10th to 90th $417 to $7,244Professionalmedian $200 · 10th to 90th $141 to $339
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 $4,365.16 Typical High $8,128.31 | Facility | None | $645.65 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | None | $147.91 | $204.17 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $295.12 | Professional | None | $173.78 | $204.17 | $295.12 |
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 $208.93 Median $208.93 Typical High $309.03 | Professional | None | $208.93 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $416.87 Typical High $1,479.11 | Facility | None | $218.78 | $416.87 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $467.74 | Professional | None | $141.25 | $208.93 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $588.84 | Facility | None | $154.88 | $208.93 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $177.83 Typical High $234.42 | Professional | None | $20.42 | $177.83 | $234.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $281.84 | Professional | None | $123.03 | $213.80 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $3,162.28 | Facility | None | $190.55 | $208.93 | $3,162.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $3,235.94 Typical High $4,365.16 | Facility | None | $147.91 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $524.81 | Professional | None | $104.71 | $104.71 | $524.81 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $4,897.79 | Facility | None | $537.03 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $371.54 | Professional | None | $120.23 | $190.55 | $371.54 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $588.84 | Facility | None | $100.00 | $199.53 | $588.84 |
Univera Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $281.84 | Professional | None | $144.54 | $199.53 | $281.84 |
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 $74.13 Median $97.72 Typical High $109.65 | Professional | 52 · Reduced service | $74.13 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $29.51 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $165.96 | Professional | 54 · Surgery only | $112.20 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.79 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $134.90 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $104.71 | $134.90 | $154.88 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $109.65 | $190.55 | $257.04 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.38 Typical High $28.18 | Professional | 55 · Aftercare only | $12.30 | $21.38 | $28.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.30 | $21.38 | $28.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $169.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $97.72 | $169.82 | $229.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $112.20 | $162.18 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $109.65 | $199.53 | $257.04 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.88 Typical High $51.29 | Professional | 55 · Aftercare only | $12.30 | $21.88 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $51.29 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $97.72 | $173.78 | $229.09 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 38th of 51
$204
AK $603FL $174
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.