How much rates vary
Facilitymedian $2,630 · 10th to 90th $331 to $5,248Professionalmedian $158 · 10th to 90th $98 to $234
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 $1,348.96 Median $4,365.16 Typical High $10,232.93 | Facility | None | $1,348.96 | $4,365.16 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $194.98 | Professional | None | $128.82 | $154.88 | $194.98 |
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 $138.04 Median $162.18 Typical High $245.47 | Professional | None | $138.04 | $162.18 | $245.47 |
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 $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $218.78 Typical High $436.52 | Facility | None | $100.00 | $218.78 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $288.40 | Professional | None | $81.28 | $134.90 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $114.82 Typical High $380.19 | Facility | None | $34.67 | $114.82 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $380.19 | Professional | None | $218.78 | $218.78 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $234.42 | Professional | None | $95.50 | $177.83 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $23,442.29 | Facility | None | $16,218.10 | $16,218.10 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $316.23 | Professional | None | $169.82 | $169.82 | $316.23 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $218.78 | Professional | None | $81.28 | $131.83 | $218.78 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $144.54 Typical High $501.19 | Facility | None | $70.79 | $144.54 | $501.19 |
Univera Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $234.42 | Professional | None | $95.50 | $154.88 | $234.42 |
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 $64.57 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $64.57 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.20 Typical High $38.90 | Professional | 53 · Discontinued | $25.70 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $114.82 Typical High $144.54 | Professional | 54 · Surgery only | $97.72 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.91 Typical High $29.51 | Professional | 55 · Aftercare only | $19.50 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.88 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $107.15 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $91.20 | $107.15 | $134.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $85.11 | $158.49 | $208.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $17.78 Typical High $23.44 | Professional | 55 · Aftercare only | $9.55 | $17.78 | $23.44 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.55 | $17.78 | $23.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $141.25 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $75.86 | $141.25 | $186.21 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $117.49 Typical High $162.18 | Professional | 53 · Discontinued | $93.33 | $117.49 | $162.18 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $208.93 | Professional | 54 · Surgery only | $85.11 | $138.04 | $208.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $15.49 Typical High $23.44 | Professional | 55 · Aftercare only | $9.55 | $15.49 | $23.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.49 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.55 | $15.49 | $23.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $123.03 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $75.86 | $123.03 | $186.21 |
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
$158
AK $437NJ $126
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.