How much rates vary
Facilitymedian $3,090 · 10th to 90th $417 to $7,244Professionalmedian $263 · 10th to 90th $186 to $490
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 $1,000.00 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,000.00 | $4,168.69 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $489.78 | Professional | None | $186.21 | $257.04 | $489.78 |
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 $223.87 Median $275.42 Typical High $512.86 | Professional | None | $223.87 | $275.42 | $512.86 |
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 $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $316.23 Typical High $645.65 | Facility | None | $100.00 | $316.23 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $501.19 | Professional | None | $128.82 | $269.15 | $501.19 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $741.31 | Facility | None | $190.55 | $223.87 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $602.56 | Professional | None | $316.23 | $354.81 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $346.74 | Professional | None | $199.53 | $239.88 | $346.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $134.90 Median $3,715.35 Typical High $5,370.32 | Facility | None | $134.90 | $3,715.35 | $5,370.32 |
Highmark BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | None | $354.81 | $354.81 | $407.38 |
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 $239.88 Median $239.88 Typical High $512.86 | Professional | None | $239.88 | $239.88 | $512.86 |
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 $131.83 Median $229.09 Typical High $457.09 | Professional | None | $131.83 | $229.09 | $457.09 |
Univera Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $741.31 | Facility | None | $154.88 | $269.15 | $741.31 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $346.74 | Professional | None | $199.53 | $269.15 | $346.74 |
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 $93.33 Median $128.82 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $51.29 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $194.98 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.70 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $181.97 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $128.82 | $181.97 | $190.55 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $177.83 | $257.04 | $309.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $19.95 | $28.18 | $34.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.95 | $28.18 | $34.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $275.42 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $154.88 | $194.98 | $223.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $177.83 | $257.04 | $309.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.18 Typical High $38.90 | Professional | 55 · Aftercare only | $19.95 | $28.18 | $38.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $28.18 Typical High $38.90 | Professional | 56 · Pre-op care only | $19.95 | $28.18 | $38.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $275.42 |
Where New York sits
The same service costs 3.9 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
$275
AK $851TX $219
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.