How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,023 to $8,318Professionalmedian $1,778 · 10th to 90th $468 to $3,388
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 $1,659.59 Median $4,786.30 Typical High $10,232.93 | Facility | None | $1,659.59 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,548.82 Typical High $2,754.23 | Professional | None | $436.52 | $1,548.82 | $2,754.23 |
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 $1,513.56 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,819.70 | $3,311.31 |
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 $2,570.40 | Professional | None | $537.03 | $537.03 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $1,513.56 Typical High $4,786.30 | Professional | None | $331.13 | $1,513.56 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $1,479.11 | Facility | None | $389.05 | $501.19 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $6,165.95 | Professional | None | $3,890.45 | $4,265.80 | $6,165.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,122.02 | $2,454.71 | $3,235.94 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,244.36 | Facility | None | $4,265.80 | $4,265.80 | $7,244.36 |
MVP Health Care Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $23,442.29 | Facility | None | $16,218.10 | $16,218.10 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,659.59 | $1,659.59 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $11,748.98 | Facility | None | $1,122.02 | $2,754.23 | $11,748.98 |
United Setting Professional Modifier None Typical Low $309.03 Median $1,479.11 Typical High $4,073.80 | Professional | None | $309.03 | $1,479.11 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $1,862.09 | Facility | None | $316.23 | $446.68 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,071.52 | $1,862.09 | $3,235.94 |
17 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 $218.78 Median $758.58 Typical High $1,148.15 | Professional | 52 · Reduced service | $218.78 | $758.58 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $302.00 Typical High $457.09 | Professional | 53 · Discontinued | $87.10 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $1,148.15 Typical High $1,698.24 | Professional | 54 · Surgery only | $323.59 | $1,148.15 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $229.09 Typical High $338.84 | Professional | 55 · Aftercare only | $66.07 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $151.36 Typical High $229.09 | Professional | 56 · Pre-op care only | $43.65 | $151.36 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $2,238.72 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,023.29 | $2,238.72 | $2,951.21 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $218.78 Typical High $288.40 | Professional | 55 · Aftercare only | $100.00 | $218.78 | $288.40 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $194.98 Typical High $257.04 | Professional | 56 · Pre-op care only | $89.13 | $194.98 | $257.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $2,041.74 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $933.25 | $2,041.74 | $2,691.53 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $288.40 Median $407.38 Typical High $1,698.24 | Facility | 54 · Surgery only | $288.40 | $407.38 | $1,698.24 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $165.96 | Facility | 55 · Aftercare only | $28.84 | $40.74 | $165.96 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $147.91 | Facility | 56 · Pre-op care only | $25.70 | $36.31 | $147.91 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $371.54 Typical High $1,548.82 | Facility | 78 · Unplanned return to OR | $263.03 | $371.54 | $1,548.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,698.24 Typical High $2,951.21 | Professional | 54 · Surgery only | $977.24 | $1,698.24 | $2,951.21 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $165.96 Typical High $288.40 | Professional | 55 · Aftercare only | $95.50 | $165.96 | $288.40 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $147.91 Typical High $257.04 | Professional | 56 · Pre-op care only | $85.11 | $147.91 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,548.82 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $891.25 | $1,548.82 | $2,691.53 |
Where New York sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 21st of 51
$1,820
IA $2,692NE $741
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.