How much rates vary
Facilitymedian $3,548 · 10th to 90th $933 to $8,318Professionalmedian $269 · 10th to 90th $182 to $479
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 $1,819.70 Median $6,309.57 Typical High $12,882.50 | Facility | None | $1,819.70 | $6,309.57 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $380.19 | Professional | None | $239.88 | $288.40 | $380.19 |
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 $229.09 Median $269.15 Typical High $489.78 | Professional | None | $229.09 | $269.15 | $489.78 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $524.81 | Professional | None | $295.12 | $295.12 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,737.80 | $2,570.40 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $562.34 | Professional | None | $165.96 | $295.12 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $109.65 Median $234.42 Typical High $776.25 | Facility | None | $109.65 | $234.42 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $758.58 | Professional | None | $346.74 | $436.52 | $758.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $549.54 | Professional | None | $245.47 | $323.59 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $3,235.94 Typical High $4,365.16 | Facility | None | $213.80 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $512.86 | Professional | None | $181.97 | $181.97 | $512.86 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $436.52 | Professional | None | $162.18 | $263.03 | $436.52 |
Univera Setting Facility Modifier None Typical Low $141.25 Median $346.74 Typical High $741.31 | Facility | None | $141.25 | $346.74 | $741.31 |
Univera Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $501.19 | Professional | None | $245.47 | $346.74 | $501.19 |
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 $120.23 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $120.23 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.99 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $199.53 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $165.96 | $199.53 | $257.04 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $316.23 Typical High $489.78 | Professional | 54 · Surgery only | $181.97 | $316.23 | $489.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $35.48 Typical High $54.95 | Professional | 55 · Aftercare only | $19.95 | $35.48 | $54.95 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $48.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $281.84 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $162.18 | $281.84 | $446.68 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $229.09 Typical High $346.74 | Professional | 53 · Discontinued | $177.83 | $229.09 | $346.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $316.23 Typical High $446.68 | Professional | 54 · Surgery only | $181.97 | $316.23 | $446.68 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $35.48 Typical High $74.13 | Professional | 55 · Aftercare only | $19.95 | $35.48 | $74.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $67.61 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $67.61 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $162.18 | $281.84 | $407.38 |
Where New York sits
The same service costs 3.7 times more in Wyoming 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· 44th of 51
$269
WY $891TX $240
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.