How much rates vary
Facilitymedian $3,090 · 10th to 90th $661 to $7,413Professionalmedian $282 · 10th to 90th $191 to $575
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 $354.81 Median $3,801.89 Typical High $8,128.31 | Facility | None | $354.81 | $3,801.89 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $549.54 | Professional | None | $257.04 | $316.23 | $549.54 |
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 $239.88 Median $281.84 Typical High $512.86 | Professional | None | $239.88 | $281.84 | $512.86 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,290.87 | Facility | None | $776.25 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $977.24 | Professional | None | $147.91 | $263.03 | $977.24 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $218.78 Typical High $741.31 | Facility | None | $34.67 | $218.78 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $562.34 | Professional | None | $302.00 | $338.84 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $363.08 | Professional | None | $181.97 | $263.03 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $239.88 Median $3,235.94 Typical High $4,365.16 | Facility | None | $239.88 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $660.69 | Professional | None | $173.78 | $173.78 | $660.69 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $691.83 | Professional | None | $162.18 | $257.04 | $691.83 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $691.83 | Facility | None | $131.83 | $245.47 | $691.83 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $363.08 | Professional | None | $181.97 | $245.47 | $363.08 |
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 $141.25 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $194.98 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $263.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $331.13 | Professional | 54 · Surgery only | $165.96 | $239.88 | $331.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.30 Typical High $37.15 | Professional | 55 · Aftercare only | $18.20 | $26.30 | $37.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $33.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $295.12 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $186.21 Typical High $281.84 | Professional | 53 · Discontinued | $141.25 | $186.21 | $281.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $239.88 | $323.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.30 Typical High $53.70 | Professional | 55 · Aftercare only | $18.20 | $26.30 | $53.70 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $47.86 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $47.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $295.12 |
Where New York sits
The same service costs 4.3 times more in Alaska 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· 44th of 51
$288
AK $1,000UT $234
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.