How much rates vary
Facilitymedian $3,090 · 10th to 90th $457 to $7,244Professionalmedian $200 · 10th to 90th $151 to $355
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 $1,348.96 Median $4,265.80 Typical High $9,772.37 | Facility | None | $1,348.96 | $4,265.80 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $239.88 | Professional | None | $169.82 | $218.78 | $239.88 |
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 $169.82 Median $199.53 Typical High $281.84 | Professional | None | $169.82 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $302.00 Typical High $426.58 | Professional | 50 · Both sides | $257.04 | $302.00 | $426.58 |
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 $229.09 Median $229.09 Typical High $323.59 | Professional | None | $229.09 | $229.09 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $1,479.11 | Facility | None | $199.53 | $380.19 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $489.78 | Professional | None | $151.36 | $218.78 | $489.78 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $173.78 Typical High $575.44 | Facility | None | $60.26 | $173.78 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $416.87 | Professional | None | $208.93 | $275.42 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $295.12 | Professional | None | $125.89 | $218.78 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $165.96 | $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 $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 $204.17 Typical High $416.87 | Professional | None | $128.82 | $204.17 | $416.87 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $208.93 Typical High $630.96 | Facility | None | $107.15 | $208.93 | $630.96 |
Univera Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $295.12 | Professional | None | $147.91 | $208.93 | $295.12 |
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 $85.11 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $85.11 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $33.88 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $162.18 Typical High $177.83 | Professional | 54 · Surgery only | $128.82 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $25.70 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $120.23 | $151.36 | $165.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $199.53 Typical High $281.84 | Professional | 54 · Surgery only | $114.82 | $199.53 | $281.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $12.59 | $21.88 | $31.62 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $21.88 Typical High $31.62 | Professional | 56 · Pre-op care only | $12.59 | $21.88 | $31.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $173.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $102.33 | $173.78 | $251.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $117.49 | $165.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $114.82 | $199.53 | $263.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $21.88 Typical High $54.95 | Professional | 55 · Aftercare only | $12.59 | $21.88 | $54.95 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $21.88 Typical High $54.95 | Professional | 56 · Pre-op care only | $12.59 | $21.88 | $54.95 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $177.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $102.33 | $177.83 | $234.42 |
Where New York sits
The same service costs 3.7 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· 42nd of 51
$200
AK $646FL $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.