How much rates vary
Facilitymedian $2,570 · 10th to 90th $240 to $4,898Professionalmedian $204 · 10th to 90th $112 to $398
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 $147.91 Median $3,090.30 Typical High $8,128.31 | Facility | None | $147.91 | $3,090.30 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $354.81 | Professional | None | $112.20 | $194.98 | $354.81 |
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 $186.21 Median $223.87 Typical High $380.19 | Professional | None | $186.21 | $223.87 | $380.19 |
CDPHP Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $288.40 | Professional | None | $169.82 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $1,096.48 | Facility | None | $100.00 | $154.88 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $707.95 | Professional | None | $95.50 | $162.18 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $61.66 Median $128.82 Typical High $457.09 | Facility | None | $61.66 | $128.82 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $436.52 | Professional | None | $245.47 | $269.15 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $263.03 | Professional | None | $138.04 | $204.17 | $263.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
MVP Health Care Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $478.63 | Professional | None | $75.86 | $75.86 | $478.63 |
United Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,365.16 | Facility | None | $338.84 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $478.63 | Professional | None | $95.50 | $177.83 | $478.63 |
Univera Setting Facility Modifier None Typical Low $89.13 Median $194.98 Typical High $346.74 | Facility | None | $89.13 | $194.98 | $346.74 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $251.19 | Professional | None | $138.04 | $194.98 | $251.19 |
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 $56.23 Median $97.72 Typical High $125.89 | Professional | 52 · Reduced service | $56.23 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $22.39 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $190.55 | Professional | 54 · Surgery only | $83.18 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.22 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $138.04 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $77.62 | $138.04 | $177.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $251.19 | Professional | 54 · Surgery only | $123.03 | $181.97 | $251.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.42 Typical High $27.54 | Professional | 55 · Aftercare only | $13.80 | $20.42 | $27.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.42 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.80 | $20.42 | $27.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $223.87 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $125.89 Typical High $208.93 | Professional | 53 · Discontinued | $95.50 | $125.89 | $208.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $123.03 | $181.97 | $234.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.42 Typical High $39.81 | Professional | 55 · Aftercare only | $13.80 | $20.42 | $39.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.42 Typical High $39.81 | Professional | 56 · Pre-op care only | $13.80 | $20.42 | $39.81 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $208.93 |
Where New York sits
The same service costs 4.5 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· 27th of 51
$214
AK $501KY $112
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.