How much rates vary
Facilitymedian $2,884 · 10th to 90th $263 to $7,244Professionalmedian $204 · 10th to 90th $141 to $372
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 $151.36 Median $1,905.46 Typical High $7,585.78 | Facility | None | $151.36 | $1,905.46 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $380.19 | Professional | None | $141.25 | $186.21 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $208.93 | Professional | None | $128.82 | $128.82 | $208.93 |
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 $173.78 Median $208.93 Typical High $371.54 | Professional | None | $173.78 | $208.93 | $371.54 |
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 $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $2,570.40 | Facility | None | $870.96 | $1,288.25 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $371.54 | Professional | None | $104.71 | $204.17 | $371.54 |
Emblem Health Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $588.84 | Facility | None | $123.03 | $186.21 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $478.63 | Professional | None | $251.19 | $275.42 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $263.03 | Professional | None | $151.36 | $186.21 | $263.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $5,128.61 | Facility | None | $870.96 | $1,445.44 | $5,128.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $398.11 | Professional | None | $218.78 | $263.03 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $151.36 Median $3,235.94 Typical High $4,365.16 | Facility | None | $151.36 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $398.11 | Professional | None | $173.78 | $173.78 | $398.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $346.74 | Professional | None | $107.15 | $181.97 | $346.74 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $204.17 Typical High $524.81 | Facility | None | $123.03 | $204.17 | $524.81 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $263.03 | Professional | None | $151.36 | $204.17 | $263.03 |
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 $70.79 Median $93.33 Typical High $102.33 | Professional | 52 · Reduced service | $70.79 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $28.18 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $141.25 Typical High $154.88 | Professional | 54 · Surgery only | $107.15 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $21.38 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.62 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.13 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $131.83 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $100.00 | $131.83 | $144.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $134.90 | $194.98 | $234.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $26.30 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $26.30 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $208.93 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $144.54 Typical High $169.82 | Professional | 53 · Discontinued | $114.82 | $144.54 | $169.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $194.98 | $245.47 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $29.51 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $29.51 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $218.78 |
Where New York sits
The same service costs 4.6 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· 45th of 51
$209
AK $794KY $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.