How much rates vary
Facilitymedian $3,162 · 10th to 90th $692 to $7,413Professionalmedian $331 · 10th to 90th $148 to $537
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 $478.63 Median $3,981.07 Typical High $8,128.31 | Facility | None | $478.63 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $380.19 Typical High $426.58 | Professional | None | $151.36 | $380.19 | $426.58 |
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 $288.40 Median $338.84 Typical High $457.09 | Professional | None | $288.40 | $338.84 | $457.09 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $537.03 | Professional | None | $204.17 | $204.17 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $2,570.40 | Facility | None | $870.96 | $1,288.25 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $346.74 Typical High $562.34 | Professional | None | $138.04 | $346.74 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $575.44 | Facility | None | $151.36 | $223.87 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $676.08 | Professional | None | $331.13 | $446.68 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $457.09 | Professional | None | $194.98 | $354.81 | $457.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $5,011.87 | Facility | None | $562.34 | $562.34 | $5,011.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $3,235.94 Typical High $4,365.16 | Facility | None | $162.18 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $912.01 | Professional | None | $134.90 | $134.90 | $912.01 |
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 $120.23 Median $263.03 Typical High $602.56 | Professional | None | $120.23 | $263.03 | $602.56 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $331.13 Typical High $537.03 | Facility | None | $97.72 | $331.13 | $537.03 |
Univera Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $457.09 | Professional | None | $229.09 | $338.84 | $457.09 |
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 $74.13 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $74.13 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $30.20 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $112.20 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $22.39 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $15.14 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $263.03 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $104.71 | $263.03 | $269.15 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 58 · Staged procedure | $173.78 | $173.78 | $173.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $302.00 Typical High $407.38 | Professional | 54 · Surgery only | $177.83 | $302.00 | $407.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $19.50 | $33.88 | $45.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.50 | $33.88 | $45.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $269.15 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $154.88 | $269.15 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $190.55 | $194.98 | $275.42 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $302.00 Typical High $407.38 | Professional | 54 · Surgery only | $177.83 | $302.00 | $407.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $34.67 Typical High $85.11 | Professional | 55 · Aftercare only | $19.50 | $34.67 | $85.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $34.67 Typical High $85.11 | Professional | 56 · Pre-op care only | $19.50 | $34.67 | $85.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $275.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $154.88 | $275.42 | $363.08 |
Where New York sits
The same service costs 4.0 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· 27th of 51
$339
AK $759KY $191
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.