How much rates vary
Facilitymedian $2,570 · 10th to 90th $363 to $4,898Professionalmedian $302 · 10th to 90th $245 to $550
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 $758.58 Median $4,677.35 Typical High $10,232.93 | Facility | None | $758.58 | $4,677.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $588.84 | Professional | None | $281.84 | $309.03 | $588.84 |
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 $257.04 Median $302.00 Typical High $407.38 | Professional | None | $257.04 | $302.00 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $446.68 Typical High $602.56 | Professional | 50 · Both sides | $380.19 | $446.68 | $602.56 |
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 $398.11 Median $398.11 Typical High $436.52 | Professional | None | $398.11 | $398.11 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $234.42 Typical High $501.19 | Facility | None | $100.00 | $234.42 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $691.83 | Professional | None | $281.84 | $302.00 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $1,174.90 | Facility | None | $257.04 | $363.08 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $630.96 | Professional | None | $288.40 | $416.87 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $426.58 | Professional | None | $181.97 | $316.23 | $426.58 |
Highmark BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $831.76 | Professional | None | $363.08 | $426.58 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $257.04 Median $3,235.94 Typical High $4,365.16 | Facility | None | $257.04 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $776.25 | Professional | None | $295.12 | $295.12 | $776.25 |
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 $213.80 Median $316.23 Typical High $707.95 | Professional | None | $213.80 | $316.23 | $707.95 |
Univera Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $1,174.90 | Facility | None | $199.53 | $288.40 | $1,174.90 |
Univera Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $426.58 | Professional | None | $213.80 | $288.40 | $426.58 |
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 $141.25 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $251.19 Typical High $354.81 | Professional | 54 · Surgery only | $144.54 | $251.19 | $354.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $66.07 Typical High $95.50 | Professional | 55 · Aftercare only | $38.02 | $66.07 | $95.50 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $45.71 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $45.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $218.78 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $125.89 | $218.78 | $309.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $239.88 | Professional | 53 · Discontinued | $158.49 | $162.18 | $239.88 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $263.03 Typical High $331.13 | Professional | 54 · Surgery only | $144.54 | $263.03 | $331.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $69.18 Typical High $162.18 | Professional | 55 · Aftercare only | $38.02 | $69.18 | $162.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.11 Typical High $77.62 | Professional | 56 · Pre-op care only | $18.20 | $33.11 | $77.62 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $229.09 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $125.89 | $229.09 | $288.40 |
Where New York sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$302
AK $1,202UT $219
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.