How much rates vary
Facilitymedian $2,291 · 10th to 90th $263 to $4,898Professionalmedian $251 · 10th to 90th $166 to $501
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 $186.21 Median $1,995.26 Typical High $7,585.78 | Facility | None | $186.21 | $1,995.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $524.81 | Professional | None | $177.83 | $251.19 | $524.81 |
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 $213.80 Median $257.04 Typical High $524.81 | Professional | None | $213.80 | $257.04 | $524.81 |
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 $281.84 Median $281.84 Typical High $446.68 | Professional | None | $281.84 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $354.81 Typical High $724.44 | Facility | None | $100.00 | $354.81 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $537.03 | Professional | None | $151.36 | $269.15 | $537.03 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $208.93 Typical High $676.08 | Facility | None | $141.25 | $208.93 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $707.95 | Professional | None | $338.84 | $371.54 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $380.19 | Professional | None | $208.93 | $288.40 | $380.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $169.82 Median $575.44 Typical High $1,584.89 | Facility | None | $169.82 | $575.44 | $1,584.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $575.44 | Professional | None | $186.21 | $338.84 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $346.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $524.81 | Professional | None | $165.96 | $165.96 | $524.81 |
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 $125.89 Median $229.09 Typical High $457.09 | Professional | None | $125.89 | $229.09 | $457.09 |
Univera Setting Facility Modifier None Typical Low $147.91 Median $288.40 Typical High $630.96 | Facility | None | $147.91 | $288.40 | $630.96 |
Univera Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $363.08 | Professional | None | $208.93 | $288.40 | $363.08 |
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 $89.13 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $89.13 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $35.48 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $123.03 | $177.83 | $204.17 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $190.55 | $269.15 | $338.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $38.02 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $38.02 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $169.82 | $239.88 | $302.00 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $158.49 | $199.53 | $223.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $190.55 | $269.15 | $338.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $40.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $40.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $169.82 | $239.88 | $302.00 |
Where New York sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$257
AK $813MD $219
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.