How much rates vary
Facilitymedian $2,630 · 10th to 90th $398 to $5,012Professionalmedian $380 · 10th to 90th $282 to $575
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
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 $331.13 Median $389.05 Typical High $562.34 | Professional | None | $331.13 | $389.05 | $562.34 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $489.78 | Facility | None | $100.00 | $223.87 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $794.33 | Professional | None | $309.03 | $316.23 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $165.96 Median $426.58 Typical High $1,412.54 | Facility | None | $165.96 | $426.58 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $741.31 | Professional | None | $371.54 | $436.52 | $741.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $537.03 | Professional | None | $281.84 | $363.08 | $537.03 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $3,235.94 Typical High $4,365.16 | Facility | None | $398.11 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $616.60 | Professional | None | $263.03 | $263.03 | $616.60 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $588.84 | Professional | None | $269.15 | $371.54 | $588.84 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $1,202.26 | Facility | None | $263.03 | $371.54 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $537.03 | Professional | None | $281.84 | $363.08 | $537.03 |
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 $213.80 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $323.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $489.78 | Professional | 54 · Surgery only | $204.17 | $316.23 | $489.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $34.67 Typical High $53.70 | Professional | 55 · Aftercare only | $22.39 | $34.67 | $53.70 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $48.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $281.84 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $181.97 | $281.84 | $436.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $275.42 Typical High $380.19 | Professional | 53 · Discontinued | $213.80 | $275.42 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $323.59 Typical High $489.78 | Professional | 54 · Surgery only | $204.17 | $323.59 | $489.78 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $36.31 Typical High $81.28 | Professional | 55 · Aftercare only | $22.39 | $36.31 | $81.28 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $72.44 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $72.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $288.40 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $181.97 | $288.40 | $436.52 |
Where New York sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 46th of 51
$380
WY $1,288UT $309
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.