How much rates vary
Facilitymedian $2,692 · 10th to 90th $339 to $5,370Professionalmedian $200 · 10th to 90th $138 to $380
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 $1,513.56 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,513.56 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $295.12 | Professional | None | $138.04 | $199.53 | $295.12 |
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 $177.83 Median $213.80 Typical High $407.38 | Professional | None | $177.83 | $213.80 | $407.38 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $331.13 | Professional | None | $213.80 | $213.80 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $1,479.11 | Facility | None | $199.53 | $380.19 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $199.53 Typical High $389.05 | Professional | None | $93.33 | $199.53 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $524.81 | Facility | None | $141.25 | $158.49 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $467.74 | Professional | None | $275.42 | $275.42 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $275.42 | Professional | None | $158.49 | $190.55 | $275.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $309.03 | Professional | None | $218.78 | $218.78 | $309.03 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $398.11 | Professional | None | $190.55 | $190.55 | $398.11 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $354.81 | Professional | None | $95.50 | $173.78 | $354.81 |
Univera Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $758.58 | Facility | None | $114.82 | $173.78 | $758.58 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $275.42 | Professional | None | $158.49 | $190.55 | $275.42 |
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 $69.18 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $39.81 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $104.71 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $138.04 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $97.72 | $138.04 | $151.36 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $199.53 | $245.47 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $27.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $27.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $218.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $151.36 | $173.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $199.53 | $245.47 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $30.90 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $30.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $30.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $218.78 |
Where New York sits
The same service costs 3.5 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· 39th of 51
$214
AK $617KY $178
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.