How much rates vary
Facilitymedian $3,236 · 10th to 90th $794 to $7,413Professionalmedian $224 · 10th to 90th $182 to $417
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 $229.09 Median $234.42 Typical High $257.04 | Professional | None | $229.09 | $234.42 | $257.04 |
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 $181.97 Median $213.80 Typical High $323.59 | Professional | None | $181.97 | $213.80 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $316.23 Typical High $478.63 | Professional | 50 · Both sides | $269.15 | $316.23 | $478.63 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $3,019.95 | Facility | None | $954.99 | $1,513.56 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $537.03 | Professional | None | $234.42 | $234.42 | $537.03 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $302.00 Typical High $977.24 | Facility | None | $190.55 | $302.00 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $489.78 | Professional | None | $223.87 | $323.59 | $489.78 |
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 $218.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $218.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $602.56 | Professional | None | $204.17 | $204.17 | $602.56 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $588.84 | Professional | None | $173.78 | $245.47 | $588.84 |
Univera Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $812.83 | Facility | None | $165.96 | $223.87 | $812.83 |
Univera Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $331.13 | Professional | None | $169.82 | $223.87 | $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 $114.82 Median $114.82 Typical High $125.89 | Professional | 52 · Reduced service | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $169.82 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $162.18 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $158.49 | $162.18 | $177.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $112.20 | $194.98 | $263.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $30.20 | $52.48 | $69.18 |
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 $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 $123.03 Median $125.89 Typical High $194.98 | Professional | 53 · Discontinued | $123.03 | $125.89 | $194.98 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $112.20 | $194.98 | $263.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $52.48 Typical High $134.90 | Professional | 55 · Aftercare only | $30.20 | $52.48 | $134.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $64.57 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $64.57 |
Univera 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 |
Where New York sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 47th of 51
$229
AK $1,023UT $191
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.