How much rates vary
Facilitymedian $2,630 · 10th to 90th $427 to $5,012Professionalmedian $214 · 10th to 90th $158 to $347
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 $204.17 Median $234.42 Typical High $295.12 | Professional | None | $204.17 | $234.42 | $295.12 |
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 $181.97 Median $213.80 Typical High $363.08 | Professional | None | $181.97 | $213.80 | $363.08 |
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 $251.19 Median $251.19 Typical High $371.54 | Professional | None | $251.19 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $676.08 Typical High $1,479.11 | Facility | None | $398.11 | $676.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $436.52 | Professional | None | $138.04 | $204.17 | $436.52 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $676.08 | Facility | None | $190.55 | $229.09 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $537.03 | Professional | None | $239.88 | $309.03 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
MVP Health Care Setting Facility Modifier None Typical Low $186.21 Median $3,235.94 Typical High $4,365.16 | Facility | None | $186.21 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | None | $251.19 | $251.19 | $398.11 |
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 $134.90 Median $199.53 Typical High $331.13 | Professional | None | $134.90 | $199.53 | $331.13 |
Univera Setting Facility Modifier None Typical Low $114.82 Median $239.88 Typical High $645.65 | Facility | None | $114.82 | $239.88 | $645.65 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
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 $102.33 Median $114.82 Typical High $144.54 | Professional | 52 · Reduced service | $102.33 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $154.88 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $204.17 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $125.89 | $223.87 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $25.12 Typical High $34.67 | Professional | 55 · Aftercare only | $14.13 | $25.12 | $34.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.12 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.13 | $25.12 | $34.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $199.53 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $112.20 | $199.53 | $275.42 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $169.82 Typical High $257.04 | Professional | 53 · Discontinued | $131.83 | $169.82 | $257.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $125.89 | $223.87 | $316.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $25.12 Typical High $50.12 | Professional | 55 · Aftercare only | $14.13 | $25.12 | $50.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $14.13 | $25.12 | $50.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $199.53 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $112.20 | $199.53 | $275.42 |
Where New York sits
The same service costs 4.2 times more in Alaska than in Texas. 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· 43rd of 51
$214
AK $741TX $178
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.