How much rates vary
Facilitymedian $2,291 · 10th to 90th $219 to $4,898Professionalmedian $178 · 10th to 90th $132 to $347
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 $165.96 Median $2,511.89 Typical High $7,762.47 | Facility | None | $165.96 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $354.81 | Professional | None | $154.88 | $177.83 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $426.58 | Professional | None | $173.78 | $218.78 | $426.58 |
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 $144.54 Median $173.78 Typical High $346.74 | Professional | None | $144.54 | $173.78 | $346.74 |
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 $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $1,479.11 | Facility | None | $177.83 | $338.84 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $371.54 | Professional | None | $141.25 | $234.42 | $371.54 |
Emblem Health Setting Facility Modifier None Typical Low $134.90 Median $204.17 Typical High $676.08 | Facility | None | $134.90 | $204.17 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $478.63 | Professional | None | $239.88 | $263.03 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $251.19 | Professional | None | $125.89 | $177.83 | $251.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $436.52 Median $812.83 Typical High $1,584.89 | Facility | None | $436.52 | $812.83 | $1,584.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $245.47 | Professional | None | $194.98 | $208.93 | $245.47 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $165.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $380.19 | Professional | None | $128.82 | $128.82 | $380.19 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $346.74 | Professional | None | $114.82 | $190.55 | $346.74 |
Univera Setting Facility Modifier None Typical Low $134.90 Median $194.98 Typical High $512.86 | Facility | None | $134.90 | $194.98 | $512.86 |
Univera Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $251.19 | Professional | None | $134.90 | $177.83 | $251.19 |
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 $77.62 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $77.62 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $38.90 | Professional | 53 · Discontinued | $30.90 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $114.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.49 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $123.03 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $107.15 | $123.03 | $134.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $186.21 | $223.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $14.45 | $20.42 | $25.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $25.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $165.96 | $199.53 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $107.15 | $138.04 | $154.88 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $190.55 | $223.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.89 Typical High $28.18 | Professional | 55 · Aftercare only | $14.45 | $20.89 | $28.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $28.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $169.82 | $199.53 |
Where New York sits
The same service costs 4.4 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· 49th of 51
$182
AK $759FL $174
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.