How much rates vary
Facilitymedian $2,754 · 10th to 90th $347 to $5,248Professionalmedian $85 · 10th to 90th $59 to $158
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 $977.24 Median $3,981.07 Typical High $8,317.64 | Facility | None | $977.24 | $3,981.07 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $151.36 | Professional | None | $60.26 | $81.28 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $72.44 Median $91.20 Typical High $169.82 | Professional | None | $72.44 | $91.20 | $169.82 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $141.25 | Professional | None | $97.72 | $97.72 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $1,096.48 | Facility | None | $100.00 | $102.33 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $158.49 | Professional | None | $42.66 | $87.10 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $74.13 Typical High $229.09 | Facility | None | $57.54 | $74.13 | $229.09 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $194.98 | Professional | None | $104.71 | $114.82 | $194.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $117.49 | Professional | None | $67.61 | $89.13 | $117.49 |
Highmark BCBS Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $134.90 | Professional | None | $93.33 | $104.71 | $134.90 |
MVP Health Care Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $194.98 | Professional | None | $79.43 | $79.43 | $194.98 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $151.36 | Professional | None | $43.65 | $75.86 | $151.36 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $89.13 Typical High $251.19 | Facility | None | $52.48 | $89.13 | $251.19 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $117.49 | Professional | None | $67.61 | $89.13 | $117.49 |
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 $30.20 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $30.20 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $12.02 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $60.26 Typical High $67.61 | Professional | 54 · Surgery only | $45.71 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $9.12 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.03 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $56.23 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $42.66 | $56.23 | $63.10 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $83.18 Typical High $104.71 | Professional | 54 · Surgery only | $60.26 | $83.18 | $104.71 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $6.76 | $9.33 | $11.75 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.76 | $9.33 | $11.75 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $74.13 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $53.70 | $74.13 | $93.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $61.66 | $70.79 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $83.18 Typical High $104.71 | Professional | 54 · Surgery only | $60.26 | $83.18 | $104.71 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.33 Typical High $13.18 | Professional | 55 · Aftercare only | $6.76 | $9.33 | $13.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.33 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.76 | $9.33 | $13.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $74.13 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $53.70 | $74.13 | $93.33 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 45th of 51
$89.13
AK $288KY $75.86
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.