How much rates vary
Facilitymedian $3,236 · 10th to 90th $813 to $7,586Professionalmedian $355 · 10th to 90th $240 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 $1,230.27 Median $4,786.30 Typical High $9,120.11 | Facility | None | $1,230.27 | $4,786.30 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $630.96 | Professional | None | $251.19 | $338.84 | $630.96 |
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 $302.00 Median $363.08 Typical High $676.08 | Professional | None | $302.00 | $363.08 | $676.08 |
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 $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
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 $177.83 Median $363.08 Typical High $660.69 | Professional | None | $177.83 | $363.08 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $1,000.00 | Facility | None | $275.42 | $331.13 | $1,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $794.33 | Professional | None | $426.58 | $467.74 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $457.09 | Professional | None | $263.03 | $354.81 | $457.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $5,623.41 | Facility | None | $1,819.70 | $1,819.70 | $5,623.41 |
Highmark BCBS Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $281.84 Median $3,235.94 Typical High $4,365.16 | Facility | None | $281.84 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $676.08 | Professional | None | $354.81 | $354.81 | $676.08 |
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 $177.83 Median $309.03 Typical High $616.60 | Professional | None | $177.83 | $309.03 | $616.60 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $354.81 Typical High $1,202.26 | Facility | None | $208.93 | $354.81 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $457.09 | Professional | None | $263.03 | $354.81 | $457.09 |
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 $123.03 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $186.21 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $173.78 | $239.88 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $338.84 | $407.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $45.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $45.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $208.93 | $295.12 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $257.04 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $338.84 | $407.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $363.08 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$363
AK $1,259UT $324
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.