How much rates vary
Facilitymedian $3,890 · 10th to 90th $871 to $9,333Professionalmedian $355 · 10th to 90th $245 to $646
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 $354.81 Median $3,981.07 Typical High $8,128.31 | Facility | None | $354.81 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $489.78 | Professional | None | $281.84 | $338.84 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $645.65 | Professional | None | $295.12 | $354.81 | $645.65 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | None | $446.68 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,148.15 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $407.38 Typical High $645.65 | Professional | None | $199.53 | $407.38 | $645.65 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $346.74 Typical High $1,096.48 | Facility | None | $251.19 | $346.74 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $812.83 | Professional | None | $426.58 | $478.63 | $812.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $467.74 | Professional | None | $263.03 | $323.59 | $467.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
MVP Health Care Setting Facility Modifier None Typical Low $316.23 Median $3,235.94 Typical High $4,365.16 | Facility | None | $316.23 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $660.69 | Professional | None | $354.81 | $354.81 | $660.69 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $630.96 | Professional | None | $204.17 | $338.84 | $630.96 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $346.74 Typical High $1,047.13 | Facility | None | $234.42 | $346.74 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $467.74 | Professional | None | $263.03 | $346.74 | $467.74 |
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 $141.25 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $141.25 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $56.23 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.18 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $416.87 | Professional | 54 · Surgery only | $234.42 | $331.13 | $416.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $46.77 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $46.77 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $208.93 | $295.12 | $371.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $199.53 | $257.04 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $234.42 | $338.84 | $416.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $51.29 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $371.54 |
Where New York sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 46th of 51
$355
AK $1,549NJ $347
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.