How much rates vary
Facilitymedian $2,884 · 10th to 90th $209 to $7,244Professionalmedian $182 · 10th to 90th $129 to $339
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 $158.49 Median $2,290.87 Typical High $7,585.78 | Facility | None | $158.49 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $346.74 | Professional | None | $134.90 | $173.78 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $204.17 | Professional | None | $74.13 | $74.13 | $204.17 |
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 $158.49 Median $190.55 Typical High $346.74 | Professional | None | $158.49 | $190.55 | $346.74 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $288.40 | Professional | None | $218.78 | $218.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $346.74 Typical High $1,479.11 | Facility | None | $181.97 | $346.74 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $338.84 | Professional | None | $97.72 | $199.53 | $338.84 |
Emblem Health Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $562.34 | Facility | None | $123.03 | $173.78 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $426.58 | Professional | None | $223.87 | $251.19 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $239.88 | Professional | None | $138.04 | $169.82 | $239.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $208.93 Median $1,584.89 Typical High $2,884.03 | Facility | None | $208.93 | $1,584.89 | $2,884.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $389.05 | Professional | None | $223.87 | $239.88 | $389.05 |
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 $812.83 Median $2,238.72 Typical High $6,309.57 | Facility | None | $812.83 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $323.59 | Professional | None | $100.00 | $173.78 | $323.59 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $524.81 | Facility | None | $117.49 | $186.21 | $524.81 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $239.88 | Professional | None | $138.04 | $186.21 | $239.88 |
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 $67.61 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $67.61 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $27.54 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $102.33 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $20.42 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.49 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $120.23 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $95.50 | $120.23 | $131.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $125.89 | $177.83 | $213.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $23.99 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $23.99 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $190.55 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $131.83 | $151.36 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $177.83 | $223.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $26.92 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $26.92 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $199.53 |
Where New York sits
The same service costs 4.0 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
$191
AK $646KY $162
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.