How much rates vary
Facilitymedian $2,291 · 10th to 90th $251 to $4,898Professionalmedian $309 · 10th to 90th $138 to $447
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 $147.91 Median $1,819.70 Typical High $7,762.47 | Facility | None | $147.91 | $1,819.70 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $371.54 | Professional | None | $138.04 | $269.15 | $371.54 |
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 $281.84 Median $338.84 Typical High $380.19 | Professional | None | $281.84 | $338.84 | $380.19 |
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 $199.53 Median $199.53 Typical High $478.63 | Professional | None | $199.53 | $199.53 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $389.05 | Facility | None | $100.00 | $208.93 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $316.23 Typical High $676.08 | Professional | None | $134.90 | $316.23 | $676.08 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $173.78 Typical High $562.34 | Facility | None | $75.86 | $173.78 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $676.08 | Professional | None | $323.59 | $446.68 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $436.52 | Professional | None | $186.21 | $323.59 | $436.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $169.82 Median $346.74 Typical High $416.87 | Facility | None | $169.82 | $346.74 | $416.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
MVP Health Care Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $758.58 | Professional | None | $93.33 | $93.33 | $758.58 |
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 $114.82 Median $251.19 Typical High $489.78 | Professional | None | $114.82 | $251.19 | $489.78 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $323.59 Typical High $467.74 | Facility | None | $95.50 | $323.59 | $467.74 |
Univera Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $436.52 | Professional | None | $218.78 | $323.59 | $436.52 |
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 $69.18 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $69.18 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $51.29 Typical High $63.10 | Professional | 53 · Discontinued | $27.54 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $104.71 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $38.02 Typical High $46.77 | Professional | 55 · Aftercare only | $20.89 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.80 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $97.72 | $177.83 | $218.78 |
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 $18.62 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $18.62 | $32.36 | $43.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $18.62 | $32.36 | $43.65 |
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 $154.88 Median $158.49 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $158.49 | $229.09 |
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 $18.62 Median $32.36 Typical High $81.28 | Professional | 55 · Aftercare only | $18.62 | $32.36 | $81.28 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $32.36 Typical High $81.28 | Professional | 56 · Pre-op care only | $18.62 | $32.36 | $81.28 |
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 3.6 times more in Wisconsin 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· 16th of 51
$309
WI $603KY $166
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.