How much rates vary
Facilitymedian $2,692 · 10th to 90th $275 to $5,012Professionalmedian $87 · 10th to 90th $45 to $170
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 $269.15 Median $3,981.07 Typical High $10,232.93 | Facility | None | $269.15 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $158.49 | Professional | None | $67.61 | $87.10 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $218.78 | Professional | None | $75.86 | $109.65 | $218.78 |
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 $77.62 Median $93.33 Typical High $177.83 | Professional | None | $77.62 | $93.33 | $177.83 |
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 $74.13 Median $74.13 Typical High $165.96 | Professional | None | $74.13 | $74.13 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $1,096.48 | Facility | None | $75.86 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $79.43 Typical High $177.83 | Professional | None | $31.62 | $79.43 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $45.71 Median $56.23 Typical High $173.78 | Facility | None | $45.71 | $56.23 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $6.17 Median $64.57 Typical High $123.03 | Professional | None | $6.17 | $64.57 | $123.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $141.25 | Professional | None | $77.62 | $104.71 | $141.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $194.98 | Professional | None | $120.23 | $134.90 | $194.98 |
MVP Health Care Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
MVP Health Care Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $204.17 | Professional | None | $44.67 | $44.67 | $204.17 |
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 $33.11 Median $72.44 Typical High $151.36 | Professional | None | $33.11 | $72.44 | $151.36 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $104.71 Typical High $251.19 | Facility | None | $38.02 | $104.71 | $251.19 |
Univera Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $141.25 | Professional | None | $77.62 | $104.71 | $141.25 |
16 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 $33.88 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $33.88 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $13.49 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $50.12 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $60.26 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $46.77 | $60.26 | $74.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $69.18 | $97.72 | $125.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.96 Typical High $14.13 | Professional | 55 · Aftercare only | $7.76 | $10.96 | $14.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.76 | $10.96 | $14.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $87.10 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $61.66 | $87.10 | $112.20 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | 59 · Distinct service | $102.33 | $141.25 | $141.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $56.23 | $70.79 | $81.28 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $69.18 | $97.72 | $125.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.96 Typical High $15.14 | Professional | 55 · Aftercare only | $7.76 | $10.96 | $15.14 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.76 | $10.96 | $15.14 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $87.10 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $61.66 | $87.10 | $112.20 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 47th of 51
$91.20
AK $263KY $81.28
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.