How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,047 to $10,965Professionalmedian $282 · 10th to 90th $219 to $447
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 $831.76 Median $4,786.30 Typical High $10,232.93 | Facility | None | $831.76 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | None | $302.00 | $338.84 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $457.09 | Professional | None | $234.42 | $275.42 | $457.09 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | None | $363.08 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,148.15 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $575.44 | Professional | None | $199.53 | $257.04 | $575.44 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $933.25 | Facility | None | $234.42 | $281.84 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $676.08 | Professional | None | $302.00 | $389.05 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $436.52 | Professional | None | $218.78 | $281.84 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $281.84 Median $4,365.16 Typical High $23,442.29 | Facility | None | $281.84 | $4,365.16 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $489.78 | Professional | None | $371.54 | $371.54 | $489.78 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $416.87 | Professional | None | $190.55 | $269.15 | $416.87 |
Univera Setting Facility Modifier None Typical Low $165.96 Median $302.00 Typical High $1,047.13 | Facility | None | $165.96 | $302.00 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $426.58 | Professional | None | $218.78 | $302.00 | $426.58 |
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 $147.91 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $263.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $281.84 Typical High $398.11 | Professional | 54 · Surgery only | $162.18 | $281.84 | $398.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $31.62 | $43.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $31.62 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.78 | $31.62 | $43.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $251.19 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $141.25 | $251.19 | $354.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $169.82 | $218.78 | $323.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $162.18 | $281.84 | $389.05 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $31.62 Typical High $69.18 | Professional | 55 · Aftercare only | $17.78 | $31.62 | $69.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $31.62 Typical High $69.18 | Professional | 56 · Pre-op care only | $17.78 | $31.62 | $69.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $251.19 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $141.25 | $251.19 | $346.74 |
Where New York sits
The same service costs 8.7 times more in Alaska than in North Dakota. 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.
Physician feeFacility fee
AK $7,504ND $861
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.