How much rates vary
Facilitymedian $3,090 · 10th to 90th $457 to $7,244Professionalmedian $240 · 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 $602.56 Median $3,981.07 Typical High $8,128.31 | Facility | None | $602.56 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $275.42 | Professional | None | $162.18 | $263.03 | $275.42 |
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 $208.93 Median $245.47 Typical High $323.59 | Professional | None | $208.93 | $245.47 | $323.59 |
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 $371.54 | Professional | None | $218.78 | $218.78 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $1,479.11 | Facility | None | $251.19 | $457.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $549.54 | Professional | None | $147.91 | $245.47 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $165.96 Typical High $549.54 | Facility | None | $60.26 | $165.96 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $478.63 | Professional | None | $239.88 | $316.23 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $331.13 | Professional | None | $141.25 | $245.47 | $331.13 |
MVP Health Care Setting Facility Modifier None Typical Low $158.49 Median $3,235.94 Typical High $4,365.16 | Facility | None | $158.49 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $537.03 | Professional | None | $162.18 | $162.18 | $537.03 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $446.68 | Professional | None | $128.82 | $213.80 | $446.68 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $239.88 Typical High $588.84 | Facility | None | $104.71 | $239.88 | $588.84 |
Univera Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $331.13 | Professional | None | $165.96 | $239.88 | $331.13 |
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 $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $33.11 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $123.03 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $114.82 | $181.97 | $181.97 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $128.82 | $223.87 | $295.12 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $24.55 Typical High $33.11 | Professional | 55 · Aftercare only | $14.13 | $24.55 | $33.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $33.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $114.82 | $199.53 | $263.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $134.90 | $190.55 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $128.82 | $223.87 | $295.12 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $24.55 Typical High $61.66 | Professional | 55 · Aftercare only | $14.13 | $24.55 | $61.66 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $61.66 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $61.66 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $114.82 | $199.53 | $263.03 |
Where New York sits
The same service costs 4.4 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· 34th of 51
$245
AK $661KY $151
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.