How much rates vary
Facilitymedian $2,630 · 10th to 90th $437 to $5,012Professionalmedian $295 · 10th to 90th $219 to $661
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 $691.83 Median $3,981.07 Typical High $8,128.31 | Facility | None | $691.83 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $512.86 | Professional | None | $251.19 | $331.13 | $512.86 |
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 $251.19 Median $295.12 Typical High $588.84 | Professional | None | $251.19 | $295.12 | $588.84 |
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 $323.59 Median $323.59 Typical High $512.86 | Professional | None | $323.59 | $323.59 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $676.08 Typical High $1,479.11 | Facility | None | $398.11 | $676.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $1,023.29 | Professional | None | $158.49 | $281.84 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $794.33 | Facility | None | $208.93 | $257.04 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $630.96 | Professional | None | $338.84 | $389.05 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $398.11 | Professional | None | $199.53 | $295.12 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $263.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $263.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $776.25 | Professional | None | $263.03 | $263.03 | $776.25 |
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 $177.83 Median $309.03 Typical High $831.76 | Professional | None | $177.83 | $309.03 | $831.76 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $794.33 | Facility | None | $131.83 | $281.84 | $794.33 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
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 $131.83 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $52.48 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $39.81 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $186.21 | $229.09 | $275.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $398.11 | Professional | 54 · Surgery only | $181.97 | $269.15 | $398.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $19.95 | $29.51 | $43.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $43.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $239.88 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $346.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $239.88 Typical High $302.00 | Professional | 53 · Discontinued | $177.83 | $239.88 | $302.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $363.08 | Professional | 54 · Surgery only | $181.97 | $269.15 | $363.08 |
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 $239.88 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $323.59 |
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· 46th of 51
$302
WI $933TX $251
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.