How much rates vary
Facilitymedian $3,162 · 10th to 90th $525 to $7,413Professionalmedian $224 · 10th to 90th $135 to $309
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 $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $275.42 | Professional | None | $173.78 | $218.78 | $275.42 |
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 $208.93 Median $245.47 Typical High $331.13 | Professional | None | $208.93 | $245.47 | $331.13 |
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 $204.17 Median $204.17 Typical High $338.84 | Professional | None | $204.17 | $204.17 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $426.58 Typical High $1,479.11 | Facility | None | $223.87 | $426.58 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $380.19 | Professional | None | $109.65 | $181.97 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $151.36 Typical High $501.19 | Facility | None | $85.11 | $151.36 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $478.63 | Professional | None | $213.80 | $234.42 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $295.12 | Professional | None | $151.36 | $223.87 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $3,235.94 Typical High $4,365.16 | Facility | None | $389.05 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $398.11 | Professional | None | $147.91 | $147.91 | $398.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,760.83 | Facility | None | $831.76 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $295.12 | Professional | None | $107.15 | $173.78 | $295.12 |
Univera Setting Facility Modifier None Typical Low $91.20 Median $213.80 Typical High $489.78 | Facility | None | $91.20 | $213.80 | $489.78 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $288.40 | Professional | None | $151.36 | $223.87 | $288.40 |
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 $87.10 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $87.10 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $190.55 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $109.65 | $199.53 | $263.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $22.39 Typical High $29.51 | Professional | 55 · Aftercare only | $12.02 | $22.39 | $29.51 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $22.39 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.02 | $22.39 | $29.51 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $177.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $97.72 | $177.83 | $234.42 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $154.88 Typical High $223.87 | Professional | 53 · Discontinued | $120.23 | $154.88 | $223.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $109.65 | $199.53 | $263.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $22.39 Typical High $47.86 | Professional | 55 · Aftercare only | $12.02 | $22.39 | $47.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $22.39 Typical High $47.86 | Professional | 56 · Pre-op care only | $12.02 | $22.39 | $47.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $177.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $97.72 | $177.83 | $234.42 |
Where New York sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 34th of 51
$224
AK $575NJ $166
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.