How much rates vary
Facilitymedian $2,570 · 10th to 90th $427 to $5,248Professionalmedian $309 · 10th to 90th $186 to $589
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 $309.03 Median $3,981.07 Typical High $8,128.31 | Facility | None | $309.03 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $549.54 | Professional | None | $186.21 | $309.03 | $549.54 |
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 $257.04 Median $309.03 Typical High $630.96 | Professional | None | $257.04 | $309.03 | $630.96 |
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 $302.00 Median $302.00 Typical High $537.03 | Professional | None | $302.00 | $302.00 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $1,737.80 | Facility | None | $549.54 | $933.25 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $660.69 | Professional | None | $165.96 | $309.03 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $162.18 Median $239.88 Typical High $741.31 | Facility | None | $162.18 | $239.88 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $794.33 | Professional | None | $416.87 | $467.74 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $446.68 | Professional | None | $251.19 | $316.23 | $446.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,949.84 Typical High $1,995.26 | Facility | None | $794.33 | $1,949.84 | $1,995.26 |
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 $234.42 Median $234.42 Typical High $575.44 | Professional | None | $234.42 | $234.42 | $575.44 |
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 $141.25 Median $269.15 Typical High $537.03 | Professional | None | $141.25 | $269.15 | $537.03 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $346.74 Typical High $741.31 | Facility | None | $158.49 | $346.74 | $741.31 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $446.68 | Professional | None | $251.19 | $346.74 | $446.68 |
16 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 $93.33 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $213.80 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $229.09 | $331.13 | $398.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $36.31 | $44.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $204.17 | $288.40 | $354.81 |
Highmark BCBS Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 51 · Multiple procedures | $407.38 | $407.38 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $190.55 | $245.47 | $281.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $229.09 | $331.13 | $398.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $25.70 | $36.31 | $50.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $50.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $204.17 | $288.40 | $354.81 |
Where New York sits
The same service costs 3.4 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
$309
AK $871KY $257
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.