How much rates vary
Facilitymedian $3,236 · 10th to 90th $933 to $7,586Professionalmedian $891 · 10th to 90th $617 to $1,660
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 $912.01 Median $4,677.35 Typical High $10,964.78 | Facility | None | $912.01 | $4,677.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,659.59 | Professional | None | $741.31 | $870.96 | $1,659.59 |
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 $758.58 Median $912.01 Typical High $1,698.24 | Professional | None | $758.58 | $912.01 | $1,698.24 |
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 $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,174.90 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,258.93 | $1,905.46 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,659.59 | Professional | None | $524.81 | $1,047.13 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $891.25 Typical High $2,818.38 | Facility | None | $630.96 | $891.25 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,023.29 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,174.90 | Professional | None | $676.08 | $812.83 | $1,174.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $6,456.54 | Facility | None | $512.86 | $1,513.56 | $6,456.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,621.81 | Professional | None | $954.99 | $1,202.26 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $5,754.40 | Facility | None | $851.14 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,737.80 | Professional | None | $794.33 | $794.33 | $1,737.80 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $512.86 Median $870.96 Typical High $1,621.81 | Professional | None | $512.86 | $870.96 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $630.96 Median $891.25 Typical High $2,818.38 | Facility | None | $630.96 | $891.25 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,174.90 | Professional | None | $676.08 | $891.25 | $1,174.90 |
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 $371.54 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $776.25 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $181.97 Typical High $223.87 | Professional | 55 · Aftercare only | $128.82 | $181.97 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $67.61 | $95.50 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $478.63 | $676.08 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $645.65 Typical High $741.31 | Professional | 53 · Discontinued | $512.86 | $645.65 | $741.31 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $776.25 | $954.99 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | 55 · Aftercare only | $128.82 | $181.97 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $95.50 Typical High $131.83 | Professional | 56 · Pre-op care only | $67.61 | $95.50 | $131.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $676.08 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $478.63 | $676.08 | $891.25 |
Where New York sits
The same service costs 4.4 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· 43rd of 51
$912
AK $3,311TX $759
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.