How much rates vary
Facilitymedian $3,236 · 10th to 90th $468 to $7,413Professionalmedian $224 · 10th to 90th $155 to $468
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 $812.83 Median $4,786.30 Typical High $8,317.64 | Facility | None | $812.83 | $4,786.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $331.13 | Professional | None | $151.36 | $229.09 | $331.13 |
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 $181.97 Median $218.78 Typical High $478.63 | Professional | None | $181.97 | $218.78 | $478.63 |
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 $269.15 Median $269.15 Typical High $416.87 | Professional | None | $269.15 | $269.15 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $323.59 Typical High $645.65 | Facility | None | $100.00 | $323.59 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $524.81 | Professional | None | $144.54 | $245.47 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $218.78 Typical High $724.44 | Facility | None | $186.21 | $218.78 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $602.56 | Professional | None | $316.23 | $346.74 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | None | $194.98 | $239.88 | $346.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $3,235.94 | Facility | None | $83.18 | $83.18 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $3,235.94 Typical High $4,365.16 | Facility | None | $213.80 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $467.74 | Professional | None | $204.17 | $204.17 | $467.74 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $436.52 | Professional | None | $125.89 | $218.78 | $436.52 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $263.03 Typical High $724.44 | Facility | None | $138.04 | $263.03 | $724.44 |
Univera Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $346.74 | Professional | None | $194.98 | $263.03 | $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 $74.13 Median $112.20 Typical High $165.96 | Professional | 52 · Reduced service | $74.13 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $44.67 Typical High $67.61 | Professional | 53 · Discontinued | $30.20 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $169.82 Typical High $251.19 | Professional | 54 · Surgery only | $112.20 | $169.82 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.88 Typical High $50.12 | Professional | 55 · Aftercare only | $22.39 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.39 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.14 | $22.39 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $158.49 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $104.71 | $158.49 | $234.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $173.78 | $251.19 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $27.54 Typical High $34.67 | Professional | 55 · Aftercare only | $19.50 | $27.54 | $34.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $34.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $190.55 | $218.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $173.78 | $251.19 | $316.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $27.54 Typical High $38.02 | Professional | 55 · Aftercare only | $19.50 | $27.54 | $38.02 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $38.02 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $281.84 |
Where New York sits
The same service costs 3.5 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· 48th of 51
$229
AK $759TX $214
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.