How much rates vary
Facilitymedian $2,692 · 10th to 90th $468 to $5,248Professionalmedian $513 · 10th to 90th $417 to $891
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $676.08 | Professional | None | $416.87 | $489.78 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $724.44 Typical High $1,000.00 | Professional | 50 · Both sides | $616.60 | $724.44 | $1,000.00 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | None | $707.95 | $707.95 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $1,737.80 | Facility | None | $186.21 | $380.19 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $1,096.48 | Professional | None | $489.78 | $501.19 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $338.84 Median $575.44 Typical High $1,862.09 | Facility | None | $338.84 | $575.44 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,000.00 | Professional | None | $467.74 | $660.69 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $676.08 | Professional | None | $288.40 | $501.19 | $676.08 |
MVP Health Care Setting Facility Modifier None Typical Low $501.19 Median $3,235.94 Typical High $4,365.16 | Facility | None | $501.19 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,288.25 | Professional | None | $524.81 | $676.08 | $1,288.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,230.27 | Professional | None | $346.74 | $524.81 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $338.84 Median $467.74 Typical High $1,995.26 | Facility | None | $338.84 | $467.74 | $1,995.26 |
Univera Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $676.08 | Professional | None | $338.84 | $467.74 | $676.08 |
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 $257.04 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $398.11 Typical High $562.34 | Professional | 54 · Surgery only | $229.09 | $398.11 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $104.71 Typical High $151.36 | Professional | 55 · Aftercare only | $61.66 | $104.71 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $50.12 Typical High $72.44 | Professional | 56 · Pre-op care only | $28.84 | $50.12 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $199.53 | $346.74 | $501.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $389.05 | Professional | 53 · Discontinued | $263.03 | $269.15 | $389.05 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $229.09 | $416.87 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $109.65 Typical High $269.15 | Professional | 55 · Aftercare only | $61.66 | $109.65 | $269.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $52.48 Typical High $128.82 | Professional | 56 · Pre-op care only | $28.84 | $52.48 | $128.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $363.08 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $199.53 | $363.08 | $467.74 |
Where New York sits
The same service costs 5.2 times more in Connecticut 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
CT $3,486FL $668
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.