How much rates vary
Facilitymedian $3,236 · 10th to 90th $676 to $7,586Professionalmedian $363 · 10th to 90th $257 to $603
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 $891.25 Median $4,168.69 Typical High $8,128.31 | Facility | None | $891.25 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $407.38 | Professional | None | $309.03 | $389.05 | $407.38 |
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 $323.59 Median $380.19 Typical High $501.19 | Professional | None | $323.59 | $380.19 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $575.44 Typical High $741.31 | Professional | 50 · Both sides | $489.78 | $575.44 | $741.31 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | None | $389.05 | $389.05 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $676.08 Typical High $1,778.28 | Facility | None | $371.54 | $676.08 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $812.83 | Professional | None | $251.19 | $363.08 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $1,047.13 | Facility | None | $275.42 | $338.84 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $707.95 | Professional | None | $346.74 | $467.74 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $501.19 | Professional | None | $213.80 | $371.54 | $501.19 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $21,877.62 Median $21,877.62 Typical High $21,877.62 | Facility | 50 · Both sides | $21,877.62 | $21,877.62 | $21,877.62 |
MVP Health Care Setting Facility Modifier None Typical Low $295.12 Median $3,235.94 Typical High $4,365.16 | Facility | None | $295.12 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $954.99 | Professional | None | $363.08 | $363.08 | $954.99 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $724.44 | Professional | None | $223.87 | $346.74 | $724.44 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $346.74 Typical High $1,071.52 | Facility | None | $181.97 | $346.74 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $501.19 | Professional | None | $251.19 | $346.74 | $501.19 |
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 $151.36 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $151.36 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $61.66 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $288.40 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $169.82 | $295.12 | $389.05 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $77.62 Typical High $104.71 | Professional | 55 · Aftercare only | $45.71 | $77.62 | $104.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $37.15 Typical High $50.12 | Professional | 56 · Pre-op care only | $21.38 | $37.15 | $50.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $147.91 | $257.04 | $346.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $295.12 | Professional | 53 · Discontinued | $199.53 | $208.93 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $169.82 | $295.12 | $389.05 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $77.62 Typical High $194.98 | Professional | 55 · Aftercare only | $45.71 | $77.62 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $37.15 Typical High $93.33 | Professional | 56 · Pre-op care only | $21.38 | $37.15 | $93.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $147.91 | $257.04 | $346.74 |
Where New York sits
The same service costs 4.8 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· 34th of 51
$372
AK $1,122TX $234
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.