How much rates vary
Facilitymedian $3,090 · 10th to 90th $490 to $7,413Professionalmedian $347 · 10th to 90th $240 to $692
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 $295.12 Median $3,090.30 Typical High $7,762.47 | Facility | None | $295.12 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $616.60 | Professional | None | $269.15 | $436.52 | $616.60 |
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 $295.12 Median $346.74 Typical High $645.65 | Professional | None | $295.12 | $346.74 | $645.65 |
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 $323.59 Median $323.59 Typical High $501.19 | Professional | None | $323.59 | $323.59 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,467.37 | Facility | None | $1,096.48 | $1,737.80 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $1,258.93 | Professional | None | $199.53 | $354.81 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $912.01 | Facility | None | $234.42 | $295.12 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $371.54 Typical High $436.52 | Professional | None | $61.66 | $371.54 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $478.63 | Professional | None | $223.87 | $331.13 | $478.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,949.84 Typical High $4,570.88 | Facility | None | $676.08 | $1,949.84 | $4,570.88 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $3,235.94 Typical High $4,365.16 | Facility | None | $251.19 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $891.25 | Professional | None | $354.81 | $354.81 | $891.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $831.76 | Professional | None | $177.83 | $316.23 | $831.76 |
Univera Setting Facility Modifier None Typical Low $134.90 Median $316.23 Typical High $794.33 | Facility | None | $134.90 | $316.23 | $794.33 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $478.63 | Professional | None | $223.87 | $331.13 | $478.63 |
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 $134.90 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $134.90 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $53.70 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $199.53 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $39.81 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.92 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $186.21 | $309.03 | $316.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $478.63 | Professional | 54 · Surgery only | $199.53 | $295.12 | $478.63 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $53.70 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $53.70 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.11 Typical High $53.70 | Professional | 56 · Pre-op care only | $22.39 | $33.11 | $53.70 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $263.03 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $177.83 | $263.03 | $426.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $239.88 Typical High $338.84 | Professional | 53 · Discontinued | $181.97 | $239.88 | $338.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $426.58 | Professional | 54 · Surgery only | $199.53 | $295.12 | $426.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $64.57 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $64.57 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.11 Typical High $64.57 | Professional | 56 · Pre-op care only | $22.39 | $33.11 | $64.57 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $263.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $177.83 | $263.03 | $380.19 |
Where New York sits
The same service costs 4.6 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· 48th of 51
$355
AK $1,259UT $275
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.