How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,318 to $10,471Professionalmedian $1,738 · 10th to 90th $589 to $2,884
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 $5,248.07 Typical High $10,232.93 | Facility | None | $1,819.70 | $5,248.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $1,659.59 Typical High $2,344.23 | Professional | None | $501.19 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,819.70 | $2,754.23 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $2,137.96 | Professional | None | $537.03 | $537.03 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $4,073.80 | Facility | None | $1,412.54 | $1,995.26 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $1,258.93 Typical High $5,248.07 | Professional | None | $331.13 | $1,258.93 | $5,248.07 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $1,995.26 | Facility | None | $416.87 | $933.25 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,905.46 | $2,884.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,454.71 | Professional | None | $933.25 | $1,318.26 | $2,454.71 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,365.16 | Facility | None | $660.69 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,754.23 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $316.23 Median $1,174.90 Typical High $3,311.31 | Professional | None | $316.23 | $1,174.90 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $1,548.82 Typical High $2,187.76 | Facility | None | $316.23 | $1,548.82 | $2,187.76 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,454.71 | Professional | None | $933.25 | $1,318.26 | $2,454.71 |
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 $251.19 Median $758.58 Typical High $1,174.90 | Professional | 52 · Reduced service | $251.19 | $758.58 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $309.03 Typical High $467.74 | Professional | 53 · Discontinued | $100.00 | $309.03 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $1,148.15 Typical High $1,737.80 | Professional | 54 · Surgery only | $380.19 | $1,148.15 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $229.09 Typical High $346.74 | Professional | 55 · Aftercare only | $75.86 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $154.88 Typical High $234.42 | Professional | 56 · Pre-op care only | $50.12 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $1,071.52 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $354.81 | $1,071.52 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,202.26 Typical High $1,949.84 | Professional | 54 · Surgery only | $851.14 | $1,202.26 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $194.98 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $107.15 Typical High $169.82 | Professional | 56 · Pre-op care only | $74.13 | $107.15 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,096.48 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $776.25 | $1,096.48 | $1,778.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $1,000.00 Typical High $1,621.81 | Professional | 53 · Discontinued | $758.58 | $1,000.00 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,202.26 Typical High $1,905.46 | Professional | 54 · Surgery only | $851.14 | $1,202.26 | $1,905.46 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $234.42 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $107.15 Typical High $204.17 | Professional | 56 · Pre-op care only | $74.13 | $107.15 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,096.48 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $776.25 | $1,096.48 | $1,905.46 |
Where New York sits
The same service costs 4.9 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· 15th of 51
$1,778
AK $3,020TX $617
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.