How much rates vary
Facilitymedian $3,090 · 10th to 90th $457 to $7,244Professionalmedian $234 · 10th to 90th $158 to $389
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 $645.65 Median $3,981.07 Typical High $8,128.31 | Facility | None | $645.65 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $269.15 | Professional | None | $165.96 | $257.04 | $269.15 |
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 $199.53 Median $234.42 Typical High $323.59 | Professional | None | $199.53 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $346.74 Typical High $489.78 | Professional | 50 · Both sides | $295.12 | $346.74 | $489.78 |
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 $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $1,479.11 | Facility | None | $251.19 | $457.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $549.54 | Professional | None | $151.36 | $245.47 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $169.82 Typical High $575.44 | Facility | None | $54.95 | $169.82 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $478.63 | Professional | None | $234.42 | $316.23 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $331.13 | Professional | None | $141.25 | $245.47 | $331.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $165.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $575.44 | Professional | None | $177.83 | $177.83 | $575.44 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $4,897.79 | Facility | None | $537.03 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $446.68 | Professional | None | $128.82 | $218.78 | $446.68 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $234.42 Typical High $616.60 | Facility | None | $104.71 | $234.42 | $616.60 |
Univera Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $331.13 | Professional | None | $169.82 | $234.42 | $331.13 |
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 $83.18 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $125.89 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $25.12 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $181.97 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $128.82 | $223.87 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $24.55 Typical High $35.48 | Professional | 55 · Aftercare only | $14.13 | $24.55 | $35.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $35.48 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $199.53 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $114.82 | $199.53 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $131.83 | $138.04 | $194.98 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $128.82 | $223.87 | $295.12 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $25.12 Typical High $53.70 | Professional | 55 · Aftercare only | $14.13 | $25.12 | $53.70 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $14.13 | $25.12 | $53.70 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $114.82 | $199.53 | $263.03 |
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· 38th of 51
$234
AK $646KY $182
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.