How much rates vary
Facilitymedian $2,188 · 10th to 90th $138 to $4,898Professionalmedian $120 · 10th to 90th $81 to $245
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 $97.72 Median $1,819.70 Typical High $7,585.78 | Facility | None | $97.72 | $1,819.70 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $257.04 | Professional | None | $89.13 | $128.82 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $309.03 | Professional | None | $100.00 | $100.00 | $309.03 |
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 $100.00 Median $120.23 Typical High $245.47 | Professional | None | $100.00 | $120.23 | $245.47 |
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 $147.91 Median $147.91 Typical High $213.80 | Professional | None | $147.91 | $147.91 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $407.38 | Facility | None | $100.00 | $194.98 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $269.15 | Professional | None | $79.43 | $134.90 | $269.15 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $117.49 Typical High $398.11 | Facility | None | $57.54 | $117.49 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $95.50 Typical High $158.49 | Professional | None | $8.13 | $95.50 | $158.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $173.78 | Professional | None | $95.50 | $128.82 | $173.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $1,071.52 | Facility | None | $323.59 | $707.95 | $1,071.52 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $316.23 | Professional | None | $154.88 | $169.82 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $257.04 | Professional | None | $74.13 | $74.13 | $257.04 |
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 $69.18 Median $120.23 Typical High $234.42 | Professional | None | $69.18 | $120.23 | $234.42 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $134.90 Typical High $281.84 | Facility | None | $77.62 | $134.90 | $281.84 |
Univera Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $173.78 | Professional | None | $95.50 | $128.82 | $173.78 |
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 $44.67 Median $64.57 Typical High $67.61 | Professional | 52 · Reduced service | $44.67 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.70 Typical High $27.54 | Professional | 53 · Discontinued | $17.78 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $102.33 | Professional | 54 · Surgery only | $66.07 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $91.20 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $61.66 | $91.20 | $95.50 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $91.20 | $134.90 | $158.49 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $10.23 | $14.79 | $17.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.23 | $14.79 | $17.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $141.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $77.62 | $97.72 | $112.20 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $91.20 | $134.90 | $158.49 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $10.23 | $14.79 | $19.95 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.79 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.23 | $14.79 | $19.95 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $141.25 |
Where New York sits
The same service costs 4.1 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· 48th of 51
$126
AK $447KY $110
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.