How much rates vary
Facilitymedian $3,311 · 10th to 90th $912 to $7,586Professionalmedian $708 · 10th to 90th $468 to $1,318
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 $1,023.29 Median $5,248.07 Typical High $9,772.37 | Facility | None | $1,023.29 | $5,248.07 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,023.29 | Professional | None | $575.44 | $691.83 | $1,023.29 |
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 $724.44 Typical High $1,380.38 | Professional | None | $588.84 | $724.44 | $1,380.38 |
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 $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
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 $1,318.26 | Professional | None | $407.38 | $812.83 | $1,318.26 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $2,187.76 | Facility | None | $524.81 | $676.08 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,621.81 | Professional | None | $851.14 | $954.99 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $912.01 | Professional | None | $524.81 | $645.65 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $5,754.40 | Facility | None | $676.08 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,348.96 | Professional | None | $457.09 | $457.09 | $1,348.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,318.26 | Professional | None | $416.87 | $691.83 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $1,995.26 | Facility | None | $478.63 | $707.95 | $1,995.26 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $912.01 | Professional | None | $524.81 | $707.95 | $912.01 |
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 $288.40 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $288.40 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $117.49 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $616.60 Typical High $812.83 | Professional | 54 · Surgery only | $426.58 | $616.60 | $812.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $100.00 | $144.54 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $52.48 | $75.86 | $91.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $380.19 | $537.03 | $707.95 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $416.87 | $524.81 | $588.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $616.60 Typical High $812.83 | Professional | 54 · Surgery only | $426.58 | $616.60 | $812.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $144.54 Typical High $194.98 | Professional | 55 · Aftercare only | $100.00 | $144.54 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $75.86 Typical High $102.33 | Professional | 56 · Pre-op care only | $52.48 | $75.86 | $102.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $380.19 | $537.03 | $707.95 |
Where New York sits
The same service costs 4.5 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· 42nd of 51
$724
AK $2,630TX $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.