How much rates vary
Facilitymedian $3,162 · 10th to 90th $759 to $7,413Professionalmedian $182 · 10th to 90th $138 to $288
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 $177.83 Median $204.17 Typical High $245.47 | Professional | None | $177.83 | $204.17 | $245.47 |
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 $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 $218.78 Median $218.78 Typical High $309.03 | Professional | None | $218.78 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,290.87 | Facility | None | $776.25 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $371.54 | Professional | None | $120.23 | $165.96 | $371.54 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $588.84 | Facility | None | $151.36 | $181.97 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $436.52 | Professional | None | $194.98 | $257.04 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $288.40 | Professional | None | $144.54 | $194.98 | $288.40 |
MVP Health Care Setting Facility Modifier None Typical Low $158.49 Median $3,235.94 Typical High $4,365.16 | Facility | None | $158.49 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $398.11 | Professional | None | $165.96 | $165.96 | $398.11 |
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 $117.49 Median $165.96 Typical High $275.42 | Professional | None | $117.49 | $165.96 | $275.42 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $549.54 | Facility | None | $100.00 | $194.98 | $549.54 |
Univera Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $288.40 | Professional | None | $144.54 | $194.98 | $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 $89.13 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $89.13 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $35.48 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $134.90 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $169.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $104.71 | $186.21 | $257.04 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $11.48 | $20.42 | $28.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.42 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.48 | $20.42 | $28.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $162.18 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $93.33 | $162.18 | $229.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $141.25 Typical High $213.80 | Professional | 53 · Discontinued | $109.65 | $141.25 | $213.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $104.71 | $186.21 | $257.04 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $20.42 Typical High $41.69 | Professional | 55 · Aftercare only | $11.48 | $20.42 | $41.69 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.42 Typical High $41.69 | Professional | 56 · Pre-op care only | $11.48 | $20.42 | $41.69 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $162.18 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $93.33 | $162.18 | $229.09 |
Where New York sits
The same service costs 4.2 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· 47th of 51
$182
AK $646NJ $155
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.