How much rates vary
Facilitymedian $2,291 · 10th to 90th $135 to $4,898Professionalmedian $95 · 10th to 90th $72 to $170
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 $93.33 Median $2,570.40 Typical High $8,128.31 | Facility | None | $93.33 | $2,570.40 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $134.90 | Professional | None | $93.33 | $109.65 | $134.90 |
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 $81.28 Median $95.50 Typical High $138.04 | Professional | None | $81.28 | $95.50 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $144.54 Typical High $208.93 | Professional | 50 · Both sides | $123.03 | $144.54 | $208.93 |
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 $112.20 Median $112.20 Typical High $147.91 | Professional | None | $112.20 | $112.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $158.49 Typical High $1,479.11 | Facility | None | $85.11 | $158.49 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $223.87 | Professional | None | $72.44 | $95.50 | $223.87 |
Emblem Health Setting Facility Modifier None Typical Low $81.28 Median $97.72 Typical High $295.12 | Facility | None | $81.28 | $97.72 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $190.55 | Professional | None | $93.33 | $123.03 | $190.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $138.04 | Professional | None | $58.88 | $100.00 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $436.52 | Facility | None | $151.36 | $257.04 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $85.11 Median $16,218.10 Typical High $23,442.29 | Facility | None | $85.11 | $16,218.10 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $288.40 | Professional | None | $104.71 | $104.71 | $288.40 |
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 $60.26 Median $91.20 Typical High $199.53 | Professional | None | $60.26 | $91.20 | $199.53 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $93.33 Typical High $398.11 | Facility | None | $53.70 | $93.33 | $398.11 |
Univera Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $138.04 | Professional | None | $69.18 | $100.00 | $138.04 |
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 $46.77 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $18.62 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $83.18 Typical High $102.33 | Professional | 54 · Surgery only | $70.79 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $77.62 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $66.07 | $77.62 | $95.50 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $53.70 | $91.20 | $123.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.00 Typical High $13.80 | Professional | 55 · Aftercare only | $5.89 | $10.00 | $13.80 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.89 | $10.00 | $13.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $81.28 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $46.77 | $81.28 | $109.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $77.62 | Professional | 53 · Discontinued | $52.48 | $53.70 | $77.62 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $53.70 | $91.20 | $123.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.00 Typical High $26.30 | Professional | 55 · Aftercare only | $5.89 | $10.00 | $26.30 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.00 Typical High $26.30 | Professional | 56 · Pre-op care only | $5.89 | $10.00 | $26.30 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $81.28 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $46.77 | $81.28 | $109.65 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 47th of 51
$95.50
AK $324FL $83.18
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.