How much rates vary
Facilitymedian $2,630 · 10th to 90th $347 to $5,012Professionalmedian $209 · 10th to 90th $166 to $380
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 $1,318.26 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $245.47 | Professional | None | $194.98 | $229.09 | $245.47 |
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 $177.83 Median $208.93 Typical High $288.40 | Professional | None | $177.83 | $208.93 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $309.03 Typical High $436.52 | Professional | 50 · Both sides | $263.03 | $309.03 | $436.52 |
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 $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $234.42 Typical High $467.74 | Facility | None | $100.00 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $524.81 | Professional | None | $190.55 | $229.09 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $812.83 | Facility | None | $141.25 | $245.47 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $478.63 | Professional | None | $213.80 | $323.59 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $323.59 | Professional | None | $138.04 | $239.88 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
MVP Health Care Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $575.44 | Professional | None | $194.98 | $194.98 | $575.44 |
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 $154.88 Median $223.87 Typical High $489.78 | Professional | None | $154.88 | $223.87 | $489.78 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $933.25 | Facility | None | $138.04 | $213.80 | $933.25 |
Univera Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $323.59 | Professional | None | $147.91 | $213.80 | $323.59 |
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 $97.72 Median $114.82 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $158.49 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $134.90 | $158.49 | $162.18 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $109.65 | $190.55 | $269.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $50.12 Typical High $72.44 | Professional | 55 · Aftercare only | $29.51 | $50.12 | $72.44 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $13.80 | $23.99 | $34.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $95.50 | $165.96 | $239.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $181.97 | Professional | 53 · Discontinued | $117.49 | $120.23 | $181.97 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $251.19 | Professional | 54 · Surgery only | $109.65 | $199.53 | $251.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $53.70 Typical High $125.89 | Professional | 55 · Aftercare only | $29.51 | $53.70 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $13.80 | $25.12 | $60.26 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $173.78 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $95.50 | $173.78 | $223.87 |
Where New York sits
The same service costs 5.0 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
$214
AK $832FL $166
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.