How much rates vary
Facilitymedian $2,570 · 10th to 90th $380 to $5,248Professionalmedian $347 · 10th to 90th $219 to $646
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 $295.12 Median $3,801.89 Typical High $8,317.64 | Facility | None | $295.12 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $645.65 | Professional | None | $218.78 | $338.84 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $758.58 | Professional | None | $338.84 | $398.11 | $758.58 |
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 $302.00 Median $363.08 Typical High $645.65 | Professional | None | $302.00 | $363.08 | $645.65 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $575.44 | Professional | None | $354.81 | $354.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $1,862.09 | Facility | None | $549.54 | $933.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $707.95 | Professional | None | $190.55 | $338.84 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $851.14 | Facility | None | $208.93 | $257.04 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $870.96 | Professional | None | $426.58 | $467.74 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $457.09 | Professional | None | $263.03 | $363.08 | $457.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $6,456.54 | Facility | None | $575.44 | $1,071.52 | $6,456.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $537.03 | Professional | None | $363.08 | $478.63 | $537.03 |
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 $239.88 Median $239.88 Typical High $812.83 | Professional | None | $239.88 | $239.88 | $812.83 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,348.96 Typical High $4,365.16 | Facility | None | $363.08 | $1,348.96 | $4,365.16 |
United Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $575.44 | Professional | None | $154.88 | $295.12 | $575.44 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $363.08 Typical High $891.25 | Facility | None | $181.97 | $363.08 | $891.25 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $457.09 | Professional | None | $263.03 | $363.08 | $457.09 |
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 $109.65 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $109.65 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $43.65 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.88 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $239.88 | $257.04 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $338.84 | $407.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $45.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $45.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $363.08 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 59 · Distinct service | $478.63 | $478.63 | $478.63 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $263.03 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $263.03 | $316.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $338.84 | $407.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $363.08 |
Where New York sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 40th of 51
$363
AK $1,000UT $302
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.