How much rates vary
Facilitymedian $3,162 · 10th to 90th $575 to $7,413Professionalmedian $263 · 10th to 90th $162 to $513
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $436.52 | Professional | None | $199.53 | $275.42 | $436.52 |
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 $234.42 Median $275.42 Typical High $489.78 | Professional | None | $234.42 | $275.42 | $489.78 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $380.19 | Professional | None | $239.88 | $239.88 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $1,479.11 | Facility | None | $275.42 | $467.74 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $912.01 | Professional | None | $128.82 | $208.93 | $912.01 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $177.83 Typical High $602.56 | Facility | None | $34.67 | $177.83 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $512.86 | Professional | None | $275.42 | $316.23 | $512.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $338.84 | Professional | None | $169.82 | $239.88 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
MVP Health Care Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $575.44 | Professional | None | $100.00 | $100.00 | $575.44 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $6,760.83 | Facility | None | $812.83 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $616.60 | Professional | None | $128.82 | $229.09 | $616.60 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $239.88 Typical High $426.58 | Facility | None | $104.71 | $239.88 | $426.58 |
Univera Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $331.13 | Professional | None | $169.82 | $239.88 | $331.13 |
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 $102.33 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $40.74 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $194.98 | $218.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $151.36 | $218.78 | $309.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $16.98 | $23.99 | $33.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.99 Typical High $33.88 | Professional | 56 · Pre-op care only | $16.98 | $23.99 | $33.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $269.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $263.03 | Professional | 53 · Discontinued | $131.83 | $173.78 | $263.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $151.36 | $218.78 | $309.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.99 Typical High $48.98 | Professional | 55 · Aftercare only | $16.98 | $23.99 | $48.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.99 Typical High $48.98 | Professional | 56 · Pre-op care only | $16.98 | $23.99 | $48.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $269.15 |
Where New York sits
The same service costs 4.3 times more in Wisconsin 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· 37th of 51
$275
WI $794KY $186
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.