How much rates vary
Facilitymedian $3,162 · 10th to 90th $355 to $7,413Professionalmedian $151 · 10th to 90th $98 to $302
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 $741.31 Median $4,677.35 Typical High $10,232.93 | Facility | None | $741.31 | $4,677.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $181.97 | Professional | None | $104.71 | $158.49 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $275.42 | Professional | None | $138.04 | $162.18 | $275.42 |
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 $141.25 Median $141.25 Typical High $213.80 | Professional | None | $141.25 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $295.12 Typical High $1,479.11 | Facility | None | $158.49 | $295.12 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $549.54 | Professional | None | $79.43 | $125.89 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $109.65 Typical High $380.19 | Facility | None | $30.20 | $109.65 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $316.23 | Professional | None | $169.82 | $194.98 | $316.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $190.55 | Professional | None | $102.33 | $147.91 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $371.54 | Professional | None | $46.77 | $46.77 | $371.54 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $371.54 | Professional | None | $81.28 | $134.90 | $371.54 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $138.04 Typical High $281.84 | Facility | None | $75.86 | $138.04 | $281.84 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $186.21 | Professional | None | $102.33 | $138.04 | $186.21 |
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 $52.48 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $20.89 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $79.43 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.99 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $112.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $74.13 | $112.20 | $125.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $91.20 | $134.90 | $173.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $10.00 | $14.79 | $19.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.79 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.00 | $14.79 | $19.05 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $117.49 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $81.28 | $117.49 | $151.36 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $100.00 Typical High $154.88 | Professional | 53 · Discontinued | $74.13 | $100.00 | $154.88 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $169.82 | Professional | 54 · Surgery only | $91.20 | $134.90 | $169.82 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.79 Typical High $29.51 | Professional | 55 · Aftercare only | $10.00 | $14.79 | $29.51 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.79 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.00 | $14.79 | $29.51 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $117.49 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $81.28 | $117.49 | $151.36 |
Where New York sits
The same service costs 4.4 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· 35th of 51
$158
AK $417KY $95.50
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.