How much rates vary
Facilitymedian $3,236 · 10th to 90th $724 to $7,586Professionalmedian $363 · 10th to 90th $251 to $617
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $416.87 | Professional | None | $302.00 | $389.05 | $416.87 |
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 $323.59 Median $371.54 Typical High $549.54 | Professional | None | $323.59 | $371.54 | $549.54 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $549.54 | Professional | None | $380.19 | $380.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $676.08 Typical High $1,778.28 | Facility | None | $363.08 | $676.08 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $794.33 | Professional | None | $239.88 | $346.74 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $331.13 Typical High $1,023.29 | Facility | None | $263.03 | $331.13 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $691.83 | Professional | None | $338.84 | $457.09 | $691.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $489.78 | Professional | None | $213.80 | $363.08 | $489.78 |
MVP Health Care Setting Facility Modifier None Typical Low $295.12 Median $3,235.94 Typical High $4,365.16 | Facility | None | $295.12 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $977.24 | Professional | None | $363.08 | $363.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $724.44 | Professional | None | $223.87 | $338.84 | $724.44 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $1,122.02 | Facility | None | $177.83 | $338.84 | $1,122.02 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $489.78 | Professional | None | $251.19 | $338.84 | $489.78 |
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 $151.36 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $151.36 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $83.18 | Professional | 53 · Discontinued | $60.26 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $288.40 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $288.40 Typical High $389.05 | Professional | 54 · Surgery only | $165.96 | $288.40 | $389.05 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $77.62 Typical High $102.33 | Professional | 55 · Aftercare only | $44.67 | $77.62 | $102.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $21.38 | $36.31 | $48.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $251.19 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $144.54 | $251.19 | $338.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $302.00 | Professional | 53 · Discontinued | $199.53 | $208.93 | $302.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $288.40 Typical High $389.05 | Professional | 54 · Surgery only | $165.96 | $288.40 | $389.05 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $77.62 Typical High $190.55 | Professional | 55 · Aftercare only | $44.67 | $77.62 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $36.31 Typical High $91.20 | Professional | 56 · Pre-op care only | $21.38 | $36.31 | $91.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $251.19 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $144.54 | $251.19 | $338.84 |
Where New York sits
The same service costs 5.2 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· 36th of 51
$363
AK $1,148TX $219
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.