How much rates vary
Facilitymedian $2,630 · 10th to 90th $389 to $5,248Professionalmedian $245 · 10th to 90th $170 to $457
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 $245.47 Median $3,548.13 Typical High $8,128.31 | Facility | None | $245.47 | $3,548.13 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $467.74 | Professional | None | $169.82 | $245.47 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $269.15 | Professional | None | $131.83 | $147.91 | $269.15 |
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 $213.80 Median $257.04 Typical High $478.63 | Professional | None | $213.80 | $257.04 | $478.63 |
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 $269.15 Median $269.15 Typical High $398.11 | Professional | None | $269.15 | $269.15 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $446.68 Typical High $1,479.11 | Facility | None | $239.88 | $446.68 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $467.74 | Professional | None | $120.23 | $245.47 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $645.65 | Facility | None | $158.49 | $199.53 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $562.34 | Professional | None | $302.00 | $331.13 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $338.84 | Professional | None | $186.21 | $251.19 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $158.49 Median $1,995.26 Typical High $2,818.38 | Facility | None | $158.49 | $1,995.26 | $2,818.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $512.86 | Professional | None | $257.04 | $338.84 | $512.86 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $3,235.94 Typical High $4,365.16 | Facility | None | $181.97 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $478.63 | Professional | None | $199.53 | $199.53 | $478.63 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,737.80 Typical High $4,897.79 | Facility | None | $537.03 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $426.58 | Professional | None | $120.23 | $213.80 | $426.58 |
Univera Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $602.56 | Facility | None | $141.25 | $251.19 | $602.56 |
Univera Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $338.84 | Professional | None | $186.21 | $251.19 | $338.84 |
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 $85.11 Median $123.03 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $181.97 Typical High $190.55 | Professional | 54 · Surgery only | $128.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $36.31 Typical High $38.02 | Professional | 55 · Aftercare only | $25.70 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $169.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $120.23 | $169.82 | $177.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $239.88 | $302.00 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $33.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $33.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $269.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $181.97 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $181.97 | $208.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $239.88 | $302.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $36.31 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $36.31 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $269.15 |
Where New York sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 38th of 51
$257
AK $776TX $214
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.