How much rates vary
Facilitymedian $2,630 · 10th to 90th $295 to $5,012Professionalmedian $209 · 10th to 90th $126 to $501
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 $645.65 Median $3,981.07 Typical High $8,128.31 | Facility | None | $645.65 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $416.87 | Professional | None | $125.89 | $245.47 | $416.87 |
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 $489.78 | Professional | None | $177.83 | $208.93 | $489.78 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $380.19 | Professional | None | $165.96 | $165.96 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $446.68 | Facility | None | $100.00 | $223.87 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $794.33 | Professional | None | $93.33 | $208.93 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $114.82 Median $144.54 Typical High $457.09 | Facility | None | $114.82 | $144.54 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $537.03 | Professional | None | $281.84 | $323.59 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $331.13 | Professional | None | $177.83 | $251.19 | $331.13 |
MVP Health Care Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $630.96 | Professional | None | $100.00 | $100.00 | $630.96 |
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 $95.50 Median $218.78 Typical High $562.34 | Professional | None | $95.50 | $218.78 | $562.34 |
Univera Setting Facility Modifier None Typical Low $89.13 Median $251.19 Typical High $346.74 | Facility | None | $89.13 | $251.19 | $346.74 |
Univera Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $323.59 | Professional | None | $177.83 | $251.19 | $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 $61.66 Median $123.03 Typical High $162.18 | Professional | 52 · Reduced service | $61.66 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $25.12 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $181.97 Typical High $245.47 | Professional | 54 · Surgery only | $93.33 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $18.62 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $12.59 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $169.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $87.10 | $169.82 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $158.49 | $223.87 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $17.78 | $25.12 | $35.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $169.82 Typical High $269.15 | Professional | 53 · Discontinued | $125.89 | $169.82 | $269.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $302.00 | Professional | 54 · Surgery only | $158.49 | $223.87 | $302.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.12 Typical High $51.29 | Professional | 55 · Aftercare only | $17.78 | $25.12 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $263.03 |
Where New York sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 34th of 51
$219
WI $490KY $135
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.