How much rates vary
Facilitymedian $2,630 · 10th to 90th $234 to $5,012Professionalmedian $132 · 10th to 90th $74 to $263
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 $138.04 Median $3,548.13 Typical High $7,762.47 | Facility | None | $138.04 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $229.09 | Professional | None | $75.86 | $138.04 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $109.65 Median $131.83 Typical High $269.15 | Professional | None | $109.65 | $131.83 | $269.15 |
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 $128.82 Median $128.82 Typical High $239.88 | Professional | None | $128.82 | $128.82 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $1,096.48 | Facility | None | $100.00 | $154.88 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $302.00 | Professional | None | $69.18 | $128.82 | $302.00 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $102.33 Typical High $346.74 | Facility | None | $34.67 | $102.33 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $331.13 | Professional | None | $177.83 | $194.98 | $331.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $190.55 | Professional | None | $102.33 | $151.36 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
MVP Health Care Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $269.15 | Professional | None | $58.88 | $58.88 | $269.15 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $234.42 | Professional | None | $60.26 | $114.82 | $234.42 |
Univera Setting Facility Modifier None Typical Low $69.18 Median $151.36 Typical High $194.98 | Facility | None | $69.18 | $151.36 | $194.98 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $190.55 | Professional | None | $102.33 | $151.36 | $190.55 |
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 $38.02 Median $61.66 Typical High $95.50 | Professional | 52 · Reduced service | $38.02 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $25.12 Typical High $38.02 | Professional | 53 · Discontinued | $15.14 | $25.12 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $93.33 Typical High $144.54 | Professional | 54 · Surgery only | $57.54 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.62 Typical High $28.84 | Professional | 55 · Aftercare only | $11.48 | $18.62 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.30 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.59 | $12.30 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $87.10 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $53.70 | $87.10 | $134.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $141.25 | $173.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $10.96 | $15.49 | $19.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.96 | $15.49 | $19.05 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $89.13 | $125.89 | $151.36 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $109.65 | $123.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $141.25 | $173.78 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.49 Typical High $21.38 | Professional | 55 · Aftercare only | $10.96 | $15.49 | $21.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.96 | $15.49 | $21.38 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $89.13 | $125.89 | $151.36 |
Where New York sits
The same service costs 4.5 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
$132
AK $407KY $91.20
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.