How much rates vary
Facilitymedian $2,630 · 10th to 90th $437 to $5,248Professionalmedian $245 · 10th to 90th $186 to $603
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $549.54 | Professional | None | $257.04 | $302.00 | $549.54 |
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 $199.53 Median $234.42 Typical High $549.54 | Professional | None | $199.53 | $234.42 | $549.54 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | None | $281.84 | $281.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,737.80 | Facility | None | $398.11 | $707.95 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $1,000.00 | Professional | None | $147.91 | $257.04 | $1,000.00 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $223.87 Typical High $741.31 | Facility | None | $64.57 | $223.87 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $630.96 | Professional | None | $331.13 | $380.19 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $446.68 | Professional | None | $199.53 | $295.12 | $446.68 |
MVP Health Care Setting Facility Modifier None Typical Low $223.87 Median $3,235.94 Typical High $4,365.16 | Facility | None | $223.87 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $660.69 | Professional | None | $223.87 | $223.87 | $660.69 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,288.25 Typical High $4,365.16 | Facility | None | $363.08 | $1,288.25 | $4,365.16 |
United Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $707.95 | Professional | None | $162.18 | $269.15 | $707.95 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $263.03 Typical High $776.25 | Facility | None | $131.83 | $263.03 | $776.25 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $446.68 | Professional | None | $199.53 | $263.03 | $446.68 |
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 $128.82 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $213.80 | $263.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $398.11 | Professional | 54 · Surgery only | $177.83 | $263.03 | $398.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $19.95 | $29.51 | $44.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $44.67 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $234.42 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $158.49 | $234.42 | $354.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $199.53 Typical High $295.12 | Professional | 53 · Discontinued | $151.36 | $199.53 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $398.11 | Professional | 54 · Surgery only | $177.83 | $263.03 | $398.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $29.51 Typical High $57.54 | Professional | 55 · Aftercare only | $19.95 | $29.51 | $57.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $57.54 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $57.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $234.42 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $158.49 | $234.42 | $354.81 |
Where New York sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 48th of 51
$257
WI $891UT $240
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.