How much rates vary
Facilitymedian $2,399 · 10th to 90th $209 to $5,012Professionalmedian $151 · 10th to 90th $95 to $316
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 $134.90 Median $3,090.30 Typical High $7,762.47 | Facility | None | $134.90 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $338.84 | Professional | None | $95.50 | $158.49 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $125.89 Median $151.36 Typical High $331.13 | Professional | None | $125.89 | $151.36 | $331.13 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $275.42 | Professional | None | $158.49 | $158.49 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $218.78 Typical High $436.52 | Facility | None | $100.00 | $218.78 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $346.74 | Professional | None | $85.11 | $154.88 | $346.74 |
Emblem Health Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $426.58 | Facility | None | $120.23 | $134.90 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $380.19 | Professional | None | $204.17 | $223.87 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | None | $123.03 | $169.82 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $199.53 Typical High $1,862.09 | Facility | None | $83.18 | $199.53 | $1,862.09 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $331.13 | Professional | None | $144.54 | $144.54 | $331.13 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,412.54 Typical High $4,365.16 | Facility | None | $363.08 | $1,412.54 | $4,365.16 |
United Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $275.42 | Professional | None | $75.86 | $138.04 | $275.42 |
Univera Setting Facility Modifier None Typical Low $81.28 Median $169.82 Typical High $512.86 | Facility | None | $81.28 | $169.82 | $512.86 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | None | $123.03 | $169.82 | $213.80 |
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 $47.86 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $47.86 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $19.05 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $117.49 Typical High $162.18 | Professional | 54 · Surgery only | $72.44 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $14.45 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $9.55 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $109.65 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $67.61 | $109.65 | $151.36 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $112.20 | $162.18 | $190.55 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $12.30 | $17.78 | $21.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $21.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $169.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $144.54 | Professional | 53 · Discontinued | $100.00 | $120.23 | $144.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $112.20 | $162.18 | $190.55 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.78 Typical High $23.44 | Professional | 55 · Aftercare only | $12.30 | $17.78 | $23.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $23.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $169.82 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 46th of 51
$158
AK $490FL $138
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.