How much rates vary
Facilitymedian $3,162 · 10th to 90th $676 to $7,413Professionalmedian $245 · 10th to 90th $155 to $389
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 $316.23 Median $3,890.45 Typical High $8,128.31 | Facility | None | $316.23 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $281.84 | Professional | None | $162.18 | $263.03 | $281.84 |
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 $213.80 Median $251.19 Typical High $331.13 | Professional | None | $213.80 | $251.19 | $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 $218.78 Median $218.78 Typical High $380.19 | Professional | None | $218.78 | $218.78 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,570.40 | Facility | None | $912.01 | $1,288.25 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $575.44 | Professional | None | $147.91 | $257.04 | $575.44 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $169.82 Typical High $562.34 | Facility | None | $60.26 | $169.82 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $489.78 | Professional | None | $245.47 | $323.59 | $489.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $346.74 | Professional | None | $147.91 | $257.04 | $346.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $3,630.78 | Facility | None | $1,348.96 | $1,348.96 | $3,630.78 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $3,235.94 Typical High $4,365.16 | Facility | None | $162.18 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $562.34 | Professional | None | $158.49 | $158.49 | $562.34 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $457.09 | Professional | None | $128.82 | $213.80 | $457.09 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $245.47 Typical High $616.60 | Facility | None | $104.71 | $245.47 | $616.60 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
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 $81.28 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $81.28 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $32.36 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $120.23 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.90 Typical High $39.81 | Professional | 55 · Aftercare only | $23.99 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.30 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.22 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $181.97 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $112.20 | $181.97 | $186.21 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $229.09 Typical High $331.13 | Professional | 54 · Surgery only | $134.90 | $229.09 | $331.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $25.70 Typical High $37.15 | Professional | 55 · Aftercare only | $14.79 | $25.70 | $37.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $14.79 | $25.70 | $37.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $204.17 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $117.49 | $204.17 | $295.12 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $138.04 | $199.53 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $234.42 Typical High $309.03 | Professional | 54 · Surgery only | $134.90 | $234.42 | $309.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $25.70 Typical High $58.88 | Professional | 55 · Aftercare only | $14.79 | $25.70 | $58.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $25.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $14.79 | $25.70 | $58.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $117.49 | $208.93 | $275.42 |
Where New York sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 33rd of 51
$251
AK $759KY $170
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.