How much rates vary
Facilitymedian $3,162 · 10th to 90th $776 to $7,413Professionalmedian $692 · 10th to 90th $479 to $1,259
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 $660.69 Median $3,890.45 Typical High $8,317.64 | Facility | None | $660.69 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,258.93 | Professional | None | $588.84 | $660.69 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,348.96 | Professional | None | $588.84 | $691.83 | $1,348.96 |
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 $933.25 Median $933.25 Typical High $1,071.52 | Professional | None | $933.25 | $933.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,230.27 | $1,905.46 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $812.83 Typical High $1,258.93 | Professional | None | $407.38 | $812.83 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $2,290.87 | Facility | None | $562.34 | $724.44 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,737.80 | Professional | None | $831.76 | $912.01 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $891.25 | Professional | None | $524.81 | $630.96 | $891.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $7,079.46 | Facility | None | $776.25 | $1,479.11 | $7,079.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,380.38 | Professional | None | $724.44 | $933.25 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $691.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,318.26 | Professional | None | $676.08 | $676.08 | $1,318.26 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,187.76 Typical High $6,309.57 | Facility | None | $831.76 | $2,187.76 | $6,309.57 |
United Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,258.93 | Professional | None | $407.38 | $691.83 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,344.23 | Facility | None | $489.78 | $691.83 | $2,344.23 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $891.25 | Professional | None | $524.81 | $691.83 | $891.25 |
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 $295.12 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $489.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $602.56 Typical High $794.33 | Professional | 54 · Surgery only | $426.58 | $602.56 | $794.33 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $74.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $52.48 | $74.13 | $89.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $524.81 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $371.54 | $524.81 | $691.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $501.19 Typical High $575.44 | Professional | 53 · Discontinued | $398.11 | $501.19 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $602.56 Typical High $794.33 | Professional | 54 · Surgery only | $426.58 | $602.56 | $794.33 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $194.98 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $74.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $52.48 | $74.13 | $102.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $524.81 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $371.54 | $524.81 | $691.83 |
Where New York sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 47th of 51
$692
AK $2,692TX $589
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.