How much rates vary
Facilitymedian $2,692 · 10th to 90th $398 to $5,248Professionalmedian $275 · 10th to 90th $204 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 $426.58 | Professional | None | $257.04 | $302.00 | $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 $234.42 Median $275.42 Typical High $549.54 | Professional | None | $234.42 | $275.42 | $549.54 |
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 $281.84 Median $281.84 Typical High $416.87 | Professional | None | $281.84 | $281.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $1,737.80 | Facility | None | $263.03 | $489.78 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $1,000.00 | Professional | None | $147.91 | $263.03 | $1,000.00 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $213.80 Typical High $707.95 | Facility | None | $64.57 | $213.80 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $588.84 | Professional | None | $338.84 | $380.19 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $389.05 | Professional | None | $194.98 | $281.84 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $741.31 | Professional | None | $302.00 | $302.00 | $741.31 |
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 $263.03 Typical High $741.31 | Professional | None | $162.18 | $263.03 | $741.31 |
Univera Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $794.33 | Facility | None | $128.82 | $213.80 | $794.33 |
Univera Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $389.05 | Professional | None | $194.98 | $251.19 | $389.05 |
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 $213.80 | Professional | 52 · Reduced service | $128.82 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $85.11 | Professional | 53 · Discontinued | $51.29 | $60.26 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $190.55 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $44.67 Typical High $63.10 | Professional | 55 · Aftercare only | $38.02 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $208.93 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $208.93 | $295.12 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $380.19 | Professional | 54 · Surgery only | $173.78 | $251.19 | $380.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $42.66 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $28.18 Typical High $42.66 | Professional | 56 · Pre-op care only | $19.50 | $28.18 | $42.66 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $338.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $199.53 Typical High $316.23 | Professional | 53 · Discontinued | $151.36 | $199.53 | $316.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $346.74 | Professional | 54 · Surgery only | $173.78 | $251.19 | $346.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $56.23 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $56.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $28.18 Typical High $56.23 | Professional | 56 · Pre-op care only | $19.50 | $28.18 | $56.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $309.03 |
Where New York sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 39th of 51
$295
WI $891TX $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.