How much rates vary
Facilitymedian $2,630 · 10th to 90th $347 to $5,012Professionalmedian $214 · 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 $426.58 | Professional | None | $125.89 | $245.47 | $426.58 |
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 $169.82 Median $169.82 Typical High $380.19 | Professional | None | $169.82 | $169.82 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $741.31 | Facility | None | $100.00 | $363.08 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $794.33 | Professional | None | $93.33 | $213.80 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $131.83 Typical High $436.52 | Facility | None | $39.81 | $131.83 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $549.54 | Professional | None | $288.40 | $331.13 | $549.54 |
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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $630.96 | Professional | None | $104.71 | $104.71 | $630.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $97.72 Median $223.87 Typical High $575.44 | Professional | None | $97.72 | $223.87 | $575.44 |
Univera Setting Facility Modifier None Typical Low $91.20 Median $251.19 Typical High $363.08 | Facility | None | $91.20 | $251.19 | $363.08 |
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 $63.10 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $63.10 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $48.98 Typical High $66.07 | Professional | 53 · Discontinued | $25.12 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $95.50 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $19.05 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.59 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $89.13 | $173.78 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $316.23 | Professional | 54 · Surgery only | $158.49 | $229.09 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $35.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.70 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $25.70 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $204.17 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $141.25 | $204.17 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $169.82 Typical High $269.15 | Professional | 53 · Discontinued | $128.82 | $169.82 | $269.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $302.00 | Professional | 54 · Surgery only | $158.49 | $229.09 | $302.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $51.29 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.70 Typical High $51.29 | Professional | 56 · Pre-op care only | $17.78 | $25.70 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $141.25 | $204.17 | $269.15 |
Where New York sits
The same service costs 3.9 times more in Alaska 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· 33rd of 51
$224
AK $562KY $145
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.