How much rates vary
Facilitymedian $2,630 · 10th to 90th $302 to $5,012Professionalmedian $182 · 10th to 90th $107 to $302
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 $147.91 Median $208.93 Typical High $269.15 | Professional | None | $147.91 | $208.93 | $269.15 |
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 $162.18 Median $194.98 Typical High $302.00 | Professional | None | $162.18 | $194.98 | $302.00 |
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 $154.88 Median $154.88 Typical High $309.03 | Professional | None | $154.88 | $154.88 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $1,479.11 | Facility | None | $177.83 | $338.84 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $165.96 Typical High $380.19 | Professional | None | $81.28 | $165.96 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $131.83 Typical High $436.52 | Facility | None | $75.86 | $131.83 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $467.74 | Professional | None | $194.98 | $275.42 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $302.00 | Professional | None | $151.36 | $194.98 | $302.00 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $354.81 | Professional | None | $107.15 | $107.15 | $354.81 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $269.15 | Professional | None | $89.13 | $162.18 | $269.15 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $194.98 Typical High $309.03 | Facility | None | $75.86 | $194.98 | $309.03 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $302.00 | Professional | None | $151.36 | $194.98 | $302.00 |
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 $74.13 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $74.13 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $29.51 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $154.88 Typical High $199.53 | Professional | 54 · Surgery only | $109.65 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.90 Typical High $39.81 | Professional | 55 · Aftercare only | $21.88 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.79 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $102.33 | $144.54 | $186.21 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $275.42 | Professional | 54 · Surgery only | $109.65 | $199.53 | $275.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $12.30 | $21.88 | $30.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $30.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $177.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $177.83 | $245.47 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $144.54 Typical High $229.09 | Professional | 53 · Discontinued | $112.20 | $144.54 | $229.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $275.42 | Professional | 54 · Surgery only | $109.65 | $199.53 | $275.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.88 Typical High $43.65 | Professional | 55 · Aftercare only | $12.30 | $21.88 | $43.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $43.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $177.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $177.83 | $245.47 |
Where New York sits
The same service costs 3.5 times more in Alaska 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
$182
AK $468TX $135
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.