How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,288 to $81,283Professionalmedian $407 · 10th to 90th $316 to $794
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 $1,513.56 Median $6,025.60 Typical High $30,199.52 | Facility | None | $1,513.56 | $6,025.60 | $30,199.52 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,548.82 | Professional | None | $467.74 | $467.74 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $10,000.00 Typical High $138,038.43 | Facility | None | $1,862.09 | $10,000.00 | $138,038.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $741.31 | Professional | None | $323.59 | $389.05 | $741.31 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $16,595.87 | Facility | None | $2,290.87 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $50,118.72 Typical High $131,825.67 | Facility | None | $1,737.80 | $50,118.72 | $131,825.67 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $1,348.96 | Professional | None | $407.38 | $416.87 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $1,479.11 | Facility | None | $426.58 | $588.84 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $794.33 | Professional | None | $398.11 | $457.09 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $645.65 | Professional | None | $204.17 | $338.84 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $398.11 Median $8,511.38 Typical High $42,657.95 | Facility | None | $398.11 | $8,511.38 | $42,657.95 |
MVP Health Care Setting Facility Modifier None Typical Low $323.59 Median $4,365.16 Typical High $89,125.09 | Facility | None | $323.59 | $4,365.16 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,047.13 | Professional | None | $478.63 | $478.63 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $7,762.47 Typical High $63,095.73 | Facility | None | $1,412.54 | $7,762.47 | $63,095.73 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $1,202.26 | Professional | None | $302.00 | $457.09 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $977.24 | Facility | None | $263.03 | $371.54 | $977.24 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $645.65 | Professional | None | $204.17 | $338.84 | $645.65 |
18 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 $234.42 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $380.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $309.03 Typical High $616.60 | Professional | 54 · Surgery only | $245.47 | $309.03 | $616.60 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.44 Typical High $45.71 | Professional | 55 · Aftercare only | $18.62 | $23.44 | $45.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $58.88 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $281.84 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $223.87 | $281.84 | $549.54 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $416.87 Typical High $616.60 | Facility | 54 · Surgery only | $245.47 | $416.87 | $616.60 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $34.67 Typical High $45.71 | Facility | 55 · Aftercare only | $18.62 | $34.67 | $45.71 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $44.67 Typical High $58.88 | Facility | 56 · Pre-op care only | $23.99 | $44.67 | $58.88 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $416.87 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $223.87 | $416.87 | $549.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $371.54 Typical High $616.60 | Professional | 54 · Surgery only | $245.47 | $371.54 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.11 Typical High $51.29 | Professional | 55 · Aftercare only | $18.62 | $33.11 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $23.99 | $41.69 | $66.07 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $371.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $223.87 | $371.54 | $549.54 |
Where New York sits
The same service costs 42.9 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $51,741MT $1,205
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.