How much rates vary
Facilitymedian $3,236 · 10th to 90th $794 to $7,586Professionalmedian $302 · 10th to 90th $209 to $550
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 $1,513.56 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,513.56 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $537.03 | Professional | None | $208.93 | $295.12 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $257.04 Median $309.03 Typical High $575.44 | Professional | None | $257.04 | $309.03 | $575.44 |
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 $331.13 Median $331.13 Typical High $478.63 | Professional | None | $331.13 | $331.13 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $2,570.40 | Facility | None | $912.01 | $1,584.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $302.00 Typical High $562.34 | Professional | None | $147.91 | $302.00 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $251.19 Typical High $831.76 | Facility | None | $218.78 | $251.19 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $691.83 | Professional | None | $371.54 | $407.38 | $691.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $407.38 | Professional | None | $223.87 | $275.42 | $407.38 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $4,786.30 | Facility | None | $50.12 | $50.12 | $4,786.30 |
MVP Health Care Setting Facility Modifier None Typical Low $229.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $229.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $575.44 | Professional | None | $269.15 | $269.15 | $575.44 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $524.81 | Professional | None | $151.36 | $263.03 | $524.81 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $309.03 Typical High $870.96 | Facility | None | $173.78 | $309.03 | $870.96 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $407.38 | Professional | None | $223.87 | $309.03 | $407.38 |
16 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 $104.71 Median $144.54 Typical High $154.88 | Professional | 52 · Reduced service | $104.71 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $218.78 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $204.17 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $204.17 | $213.80 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $204.17 | $288.40 | $363.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $40.74 | Professional | 55 · Aftercare only | $22.39 | $32.36 | $40.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $40.74 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $323.59 |
Highmark BCBS Setting Professional Modifier 58 · Staged procedure Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 58 · Staged procedure | $288.40 | $288.40 | $288.40 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $173.78 | $223.87 | $251.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $204.17 | $288.40 | $363.08 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $44.67 | Professional | 55 · Aftercare only | $22.39 | $32.36 | $44.67 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $44.67 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $323.59 |
Where New York sits
The same service costs 4.0 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
$309
AK $1,072KY $269
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.