How much rates vary
Facilitymedian $3,467 · 10th to 90th $955 to $7,762Professionalmedian $398 · 10th to 90th $288 to $813
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 $1,479.11 Median $4,677.35 Typical High $8,128.31 | Facility | None | $1,479.11 | $4,677.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $512.86 | Professional | None | $331.13 | $501.19 | $512.86 |
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 $354.81 Median $416.87 Typical High $741.31 | Professional | None | $354.81 | $416.87 | $741.31 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | None | $389.05 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,884.03 Typical High $5,623.41 | Facility | None | $1,148.15 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $1,445.44 | Professional | None | $239.88 | $407.38 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $1,023.29 | Facility | None | $251.19 | $323.59 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $794.33 | Professional | None | $398.11 | $489.78 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $549.54 | Professional | None | $257.04 | $380.19 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $309.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $977.24 | Professional | None | $354.81 | $354.81 | $977.24 |
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 $208.93 Median $363.08 Typical High $1,000.00 | Professional | None | $208.93 | $363.08 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $933.25 | Facility | None | $162.18 | $354.81 | $933.25 |
Univera Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $549.54 | Professional | None | $257.04 | $380.19 | $549.54 |
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 $165.96 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $165.96 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $100.00 Typical High $102.33 | Professional | 53 · Discontinued | $66.07 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.11 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $229.09 | $354.81 | $354.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $338.84 Typical High $549.54 | Professional | 54 · Surgery only | $229.09 | $338.84 | $549.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.02 Typical High $61.66 | Professional | 55 · Aftercare only | $25.70 | $38.02 | $61.66 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $61.66 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $61.66 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $275.42 Typical High $389.05 | Professional | 53 · Discontinued | $208.93 | $275.42 | $389.05 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $338.84 Typical High $489.78 | Professional | 54 · Surgery only | $229.09 | $338.84 | $489.78 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.02 Typical High $74.13 | Professional | 55 · Aftercare only | $25.70 | $38.02 | $74.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $74.13 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $74.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $436.52 |
Where New York sits
The same service costs 4.8 times more in Alaska 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· 45th of 51
$417
AK $1,549UT $324
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.