How much rates vary
Facilitymedian $3,090 · 10th to 90th $631 to $7,244Professionalmedian $263 · 10th to 90th $178 to $468
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 $1,122.02 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,122.02 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $436.52 | Professional | None | $194.98 | $239.88 | $436.52 |
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 $218.78 Median $263.03 Typical High $478.63 | Professional | None | $218.78 | $263.03 | $478.63 |
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 $316.23 Median $316.23 Typical High $407.38 | Professional | None | $316.23 | $316.23 | $407.38 |
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 $141.25 Median $288.40 Typical High $478.63 | Professional | None | $141.25 | $288.40 | $478.63 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $776.25 | Facility | None | $186.21 | $245.47 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $588.84 | Professional | None | $309.03 | $346.74 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $331.13 | Professional | None | $190.55 | $257.04 | $331.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $6,165.95 | Facility | None | $1,023.29 | $1,202.26 | $6,165.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | None | $288.40 | $288.40 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $223.87 Median $3,235.94 Typical High $4,365.16 | Facility | None | $223.87 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $489.78 | Professional | None | $269.15 | $269.15 | $489.78 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $4,897.79 | Facility | None | $537.03 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $467.74 | Professional | None | $144.54 | $239.88 | $467.74 |
Univera Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $794.33 | Facility | None | $169.82 | $257.04 | $794.33 |
Univera Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $331.13 | Professional | None | $190.55 | $257.04 | $331.13 |
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 $97.72 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $97.72 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $39.81 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $147.91 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $169.82 | $181.97 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $173.78 | $245.47 | $295.12 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $19.05 | $27.54 | $33.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $33.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $263.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $186.21 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $186.21 | $213.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $173.78 | $245.47 | $295.12 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $27.54 | $37.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $37.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $263.03 |
Where New York sits
The same service costs 3.9 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· 43rd of 51
$269
AK $912KY $234
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.