How much rates vary
Facilitymedian $3,236 · 10th to 90th $891 to $7,413Professionalmedian $708 · 10th to 90th $490 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 $1,000.00 Median $4,786.30 Typical High $8,317.64 | Facility | None | $1,000.00 | $4,786.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,230.27 | Professional | None | $537.03 | $660.69 | $1,230.27 |
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 $707.95 Typical High $1,318.26 | Professional | None | $588.84 | $707.95 | $1,318.26 |
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 $851.14 Median $851.14 Typical High $1,096.48 | Professional | None | $851.14 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,148.15 | $1,905.46 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $758.58 Typical High $1,288.25 | Professional | None | $380.19 | $758.58 | $1,288.25 |
Emblem Health Setting Facility Modifier None Typical Low $371.54 Median $630.96 Typical High $2,089.30 | Facility | None | $371.54 | $630.96 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,584.89 | Professional | None | $851.14 | $933.25 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $933.25 | Professional | None | $512.86 | $630.96 | $933.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $933.25 | Professional | None | $724.44 | $851.14 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $630.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,318.26 | Professional | None | $741.31 | $741.31 | $1,318.26 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,288.25 | Professional | None | $389.05 | $645.65 | $1,288.25 |
Univera Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $1,862.09 | Facility | None | $446.68 | $691.83 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $933.25 | Professional | None | $512.86 | $691.83 | $933.25 |
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 $269.15 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $398.11 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $371.54 | $467.74 | $489.78 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 79 · Unrelated procedure after surgery | $1,513.56 | $1,513.56 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $416.87 | $602.56 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $97.72 | $141.25 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $51.29 | $74.13 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $524.81 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $371.54 | $524.81 | $660.69 |
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 $416.87 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $416.87 | $602.56 | $758.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $141.25 Typical High $190.55 | Professional | 55 · Aftercare only | $97.72 | $141.25 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $74.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $51.29 | $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 4.2 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· 40th of 51
$724
AK $2,455TX $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.