How much rates vary
Facilitymedian $2,291 · 10th to 90th $234 to $4,898Professionalmedian $209 · 10th to 90th $132 to $417
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 $2,290.87 Typical High $7,585.78 | Facility | None | $138.04 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $416.87 | Professional | None | $131.83 | $204.17 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $457.09 | Professional | None | $251.19 | $251.19 | $457.09 |
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 $177.83 Median $213.80 Typical High $436.52 | Professional | None | $177.83 | $213.80 | $436.52 |
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 $213.80 Median $213.80 Typical High $371.54 | Professional | None | $213.80 | $213.80 | $371.54 |
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 $117.49 Median $218.78 Typical High $446.68 | Professional | None | $117.49 | $218.78 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $512.86 | Facility | None | $102.33 | $154.88 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $588.84 | Professional | None | $281.84 | $309.03 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $302.00 | Professional | None | $173.78 | $239.88 | $302.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $426.58 Typical High $1,174.90 | Facility | None | $223.87 | $426.58 | $1,174.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $338.84 | Professional | None | $239.88 | $309.03 | $338.84 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $3,235.94 Typical High $4,365.16 | Facility | None | $147.91 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $426.58 | Professional | None | $144.54 | $144.54 | $426.58 |
United Setting Facility Modifier None Typical Low $354.81 Median $1,148.15 Typical High $4,365.16 | Facility | None | $354.81 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $363.08 | Professional | None | $95.50 | $181.97 | $363.08 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $239.88 Typical High $407.38 | Facility | None | $112.20 | $239.88 | $407.38 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $302.00 | Professional | None | $173.78 | $239.88 | $302.00 |
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 $66.07 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $66.07 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $26.30 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $100.00 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.18 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $93.33 | $141.25 | $169.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $158.49 | $223.87 | $269.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $17.38 | $24.55 | $30.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $24.55 | $30.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $239.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $128.82 | $165.96 | $186.21 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $158.49 | $223.87 | $269.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $17.38 | $24.55 | $33.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $17.38 | $24.55 | $33.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $239.88 |
Where New York sits
The same service costs 3.5 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· 44th of 51
$214
AK $631KY $182
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.