How much rates vary
Facilitymedian $3,162 · 10th to 90th $661 to $7,413Professionalmedian $275 · 10th to 90th $191 to $457
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 $218.78 Median $281.84 Typical High $363.08 | Professional | None | $218.78 | $281.84 | $363.08 |
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 $457.09 | Professional | None | $239.88 | $281.84 | $457.09 |
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 $501.19 | Professional | None | $281.84 | $281.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $1,778.28 | Facility | None | $389.05 | $724.44 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $562.34 | Professional | None | $158.49 | $275.42 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $776.25 | Facility | None | $223.87 | $269.15 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $794.33 | Professional | None | $457.09 | $457.09 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | None | $239.88 | $309.03 | $478.63 |
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 $208.93 Median $208.93 Typical High $524.81 | Professional | None | $208.93 | $208.93 | $524.81 |
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 $154.88 Median $269.15 Typical High $426.58 | Professional | None | $154.88 | $269.15 | $426.58 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $263.03 Typical High $794.33 | Facility | None | $131.83 | $263.03 | $794.33 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | None | $239.88 | $309.03 | $478.63 |
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 $107.15 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $107.15 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $52.48 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.30 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $181.97 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $181.97 | $239.88 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $323.59 Typical High $426.58 | Professional | 54 · Surgery only | $173.78 | $323.59 | $426.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $19.05 | $36.31 | $47.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $36.31 Typical High $47.86 | Professional | 56 · Pre-op care only | $19.05 | $36.31 | $47.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $154.88 | $288.40 | $380.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $229.09 Typical High $323.59 | Professional | 53 · Discontinued | $177.83 | $229.09 | $323.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $323.59 Typical High $426.58 | Professional | 54 · Surgery only | $173.78 | $323.59 | $426.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $36.31 Typical High $69.18 | Professional | 55 · Aftercare only | $19.05 | $36.31 | $69.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $36.31 Typical High $69.18 | Professional | 56 · Pre-op care only | $19.05 | $36.31 | $69.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $154.88 | $288.40 | $380.19 |
Where New York sits
The same service costs 3.5 times more in Alaska 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· 40th of 51
$275
AK $813KY $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.