How much rates vary
Facilitymedian $2,455 · 10th to 90th $186 to $5,012Professionalmedian $170 · 10th to 90th $117 to $275
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 $158.49 Median $3,467.37 Typical High $7,762.47 | Facility | None | $158.49 | $3,467.37 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $245.47 | Professional | None | $138.04 | $173.78 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $162.18 | Professional | None | $107.15 | $151.36 | $162.18 |
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 $151.36 Median $177.83 Typical High $208.93 | Professional | None | $151.36 | $177.83 | $208.93 |
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 $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $371.54 | Facility | None | $100.00 | $165.96 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $338.84 | Professional | None | $117.49 | $144.54 | $338.84 |
Emblem Health Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $457.09 | Facility | None | $120.23 | $141.25 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | None | $144.54 | $190.55 | $288.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $181.97 | Professional | None | $114.82 | $147.91 | $181.97 |
Highmark BCBS Setting Facility Modifier None Typical Low $54.95 Median $575.44 Typical High $2,570.40 | Facility | None | $54.95 | $575.44 | $2,570.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $4,365.16 Typical High $36,307.81 | Facility | None | $147.91 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $338.84 | Professional | None | $85.11 | $85.11 | $338.84 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $354.81 | Professional | None | $91.20 | $162.18 | $354.81 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $338.84 | Facility | None | $107.15 | $144.54 | $338.84 |
Univera Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $173.78 | Professional | None | $114.82 | $144.54 | $173.78 |
14 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 $75.86 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $75.86 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $30.90 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $114.82 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $26.30 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $109.65 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $107.15 | $109.65 | $123.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $131.83 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $131.83 | $173.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $19.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $19.05 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $117.49 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $91.20 | $117.49 | $154.88 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $102.33 | $131.83 | $162.18 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $38.02 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $38.02 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $38.02 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $38.02 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $117.49 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $91.20 | $117.49 | $144.54 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 35th of 51
$170
AK $501FL $129
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.