How much rates vary
Facilitymedian $2,692 · 10th to 90th $355 to $5,012Professionalmedian $138 · 10th to 90th $98 to $282
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 $741.31 Median $4,677.35 Typical High $10,232.93 | Facility | None | $741.31 | $4,677.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $251.19 | Professional | None | $125.89 | $154.88 | $251.19 |
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 $123.03 Median $147.91 Typical High $251.19 | Professional | None | $123.03 | $147.91 | $251.19 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | None | $147.91 | $147.91 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $1,096.48 | Facility | None | $100.00 | $154.88 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $489.78 | Professional | None | $89.13 | $147.91 | $489.78 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $380.19 | Facility | None | $50.12 | $112.20 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $295.12 | Professional | None | $158.49 | $181.97 | $295.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $208.93 | Professional | None | $97.72 | $138.04 | $208.93 |
MVP Health Care Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
MVP Health Care Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $331.13 | Professional | None | $74.13 | $74.13 | $331.13 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $338.84 | Professional | None | $79.43 | $125.89 | $338.84 |
Univera Setting Facility Modifier None Typical Low $61.66 Median $125.89 Typical High $316.23 | Facility | None | $61.66 | $125.89 | $316.23 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $208.93 | Professional | None | $97.72 | $128.82 | $208.93 |
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 $63.10 Median $70.79 Typical High $91.20 | Professional | 52 · Reduced service | $63.10 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $27.54 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $100.00 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $87.10 | $100.00 | $128.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $125.89 Typical High $208.93 | Professional | 54 · Surgery only | $89.13 | $125.89 | $208.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $23.44 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $23.44 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.80 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.77 | $13.80 | $23.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $186.21 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $89.13 Typical High $144.54 | Professional | 53 · Discontinued | $67.61 | $89.13 | $144.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $125.89 Typical High $190.55 | Professional | 54 · Surgery only | $89.13 | $125.89 | $190.55 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $28.18 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $28.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.80 Typical High $28.18 | Professional | 56 · Pre-op care only | $9.77 | $13.80 | $28.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $165.96 |
Where New York sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 34th of 51
$148
AK $437KY $105
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.