How much rates vary
Facilitymedian $2,692 · 10th to 90th $479 to $5,495Professionalmedian $275 · 10th to 90th $186 to $513
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 $263.03 Median $4,073.80 Typical High $8,317.64 | Facility | None | $263.03 | $4,073.80 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $524.81 | Professional | None | $186.21 | $269.15 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $562.34 | Professional | None | $147.91 | $295.12 | $562.34 |
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 $239.88 Median $288.40 Typical High $524.81 | Professional | None | $239.88 | $288.40 | $524.81 |
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 $295.12 Median $295.12 Typical High $446.68 | Professional | None | $295.12 | $295.12 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,737.80 | Facility | None | $524.81 | $891.25 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $524.81 | Professional | None | $131.83 | $269.15 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $707.95 | Facility | None | $173.78 | $218.78 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $630.96 | Professional | None | $338.84 | $371.54 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $363.08 | Professional | None | $208.93 | $251.19 | $363.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $977.24 Typical High $2,290.87 | Facility | None | $50.12 | $977.24 | $2,290.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $575.44 | Professional | None | $288.40 | $371.54 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $199.53 Median $3,235.94 Typical High $4,365.16 | Facility | None | $199.53 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $524.81 | Professional | None | $218.78 | $218.78 | $524.81 |
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 $131.83 Median $239.88 Typical High $478.63 | Professional | None | $131.83 | $239.88 | $478.63 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $281.84 Typical High $707.95 | Facility | None | $158.49 | $281.84 | $707.95 |
Univera Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $363.08 | Professional | None | $208.93 | $281.84 | $363.08 |
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 $93.33 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $53.70 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $213.80 | Professional | 54 · Surgery only | $141.25 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $199.53 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $186.21 | $269.15 | $323.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $36.31 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $36.31 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $288.40 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $204.17 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $204.17 | $234.42 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $186.21 | $269.15 | $323.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $40.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $40.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $288.40 |
Where New York sits
The same service costs 3.6 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· 41st of 51
$288
AK $851KY $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.