How much rates vary
Facilitymedian $251 · 10th to 90th $120 to $794Professionalmedian $417 · 10th to 90th $324 to $676
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 $407.38 Median $446.68 Typical High $4,897.79 | Facility | None | $407.38 | $446.68 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $457.09 | Professional | None | $407.38 | $446.68 | $457.09 |
BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $426.58 | Facility | None | $229.09 | $229.09 | $426.58 |
BCBS Setting Professional Modifier None Typical Low $107.15 Median $575.44 Typical High $812.83 | Professional | None | $107.15 | $575.44 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $616.60 | Professional | None | $245.47 | $363.08 | $616.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $467.74 Typical High $933.25 | Facility | None | $85.11 | $467.74 | $933.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $467.74 | Professional | None | $323.59 | $416.87 | $467.74 |
Priority Health Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $501.19 | Professional | None | $245.47 | $338.84 | $501.19 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $416.87 | Professional | None | $316.23 | $354.81 | $416.87 |
12 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 $204.17 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $323.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $213.80 | $229.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $85.11 | $91.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $316.23 | $346.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $69.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $45.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $288.40 | $295.12 | $323.59 |
Where Michigan sits
The same service costs 6.3 times more in New York 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.
Physician feeFacility fee
NY $2,828FL $449
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.