How much rates vary
Facilitymedian $3,467 · 10th to 90th $912 to $7,586Professionalmedian $257 · 10th to 90th $191 to $537
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 $1,318.26 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $489.78 | Professional | None | $169.82 | $218.78 | $489.78 |
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 $218.78 Median $263.03 Typical High $426.58 | Professional | None | $218.78 | $263.03 | $426.58 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | None | $263.03 | $263.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $5,623.41 | Facility | None | $954.99 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $776.25 | Professional | None | $190.55 | $257.04 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $691.83 | Facility | None | $190.55 | $223.87 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $501.19 | Professional | None | $263.03 | $302.00 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $338.84 | Professional | None | $165.96 | $229.09 | $338.84 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $3,235.94 Typical High $4,365.16 | Facility | None | $181.97 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $588.84 | Professional | None | $338.84 | $588.84 | $588.84 |
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 $162.18 Median $263.03 Typical High $524.81 | Professional | None | $162.18 | $263.03 | $524.81 |
Univera Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $954.99 | Facility | None | $134.90 | $229.09 | $954.99 |
Univera Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $316.23 | Professional | None | $165.96 | $229.09 | $316.23 |
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 $85.11 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $85.11 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $125.89 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $117.49 | $151.36 | $169.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $208.93 Typical High $323.59 | Professional | 54 · Surgery only | $147.91 | $208.93 | $323.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $35.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $288.40 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $151.36 Typical High $251.19 | Professional | 53 · Discontinued | $112.20 | $151.36 | $251.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $147.91 | $208.93 | $288.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $47.86 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $47.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $47.86 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $47.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $275.42 |
Where New York sits
The same service costs 4.4 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· 34th of 51
$263
AK $871UT $200
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.