How much rates vary
Facilitymedian $3,311 · 10th to 90th $676 to $7,762Professionalmedian $263 · 10th to 90th $195 to $437
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 $1,659.59 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,659.59 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $398.11 | Professional | None | $234.42 | $331.13 | $398.11 |
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 $229.09 Median $269.15 Typical High $436.52 | Professional | None | $229.09 | $269.15 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $407.38 Typical High $645.65 | Professional | 50 · Both sides | $346.74 | $407.38 | $645.65 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $457.09 | Professional | None | $275.42 | $275.42 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $562.34 Typical High $1,479.11 | Facility | None | $331.13 | $562.34 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $524.81 | Professional | None | $158.49 | $263.03 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $707.95 | Facility | None | $100.00 | $208.93 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $575.44 | Professional | None | $288.40 | $380.19 | $575.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $398.11 | Professional | None | $194.98 | $263.03 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $239.88 Median $3,235.94 Typical High $4,365.16 | Facility | None | $239.88 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $426.58 | Professional | None | $245.47 | $245.47 | $426.58 |
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 $162.18 Median $257.04 Typical High $426.58 | Professional | None | $162.18 | $257.04 | $426.58 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $776.25 | Facility | None | $190.55 | $288.40 | $776.25 |
Univera Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $398.11 | Professional | None | $194.98 | $269.15 | $398.11 |
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 $117.49 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $117.49 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.44 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $165.96 | $234.42 | $269.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $239.88 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $79.43 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $30.20 | $39.81 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $208.93 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $154.88 | $194.98 | $269.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $239.88 | $316.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $128.82 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $128.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.20 Typical High $64.57 | Professional | 56 · Pre-op care only | $25.12 | $30.20 | $64.57 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $208.93 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $173.78 | $208.93 | $288.40 |
Where New York sits
The same service costs 4.3 times more in Wyoming 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· 44th of 51
$269
WY $933UT $219
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.