How much rates vary
Facilitymedian $2,630 · 10th to 90th $234 to $5,012Professionalmedian $93 · 10th to 90th $72 to $174
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Professional | None | $75.86 | $100.00 | $154.88 |
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 $77.62 Median $91.20 Typical High $141.25 | Professional | None | $77.62 | $91.20 | $141.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $213.80 | Professional | 50 · Both sides | $117.49 | $138.04 | $213.80 |
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 $109.65 Median $109.65 Typical High $158.49 | Professional | None | $109.65 | $109.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $229.09 Typical High $1,584.89 | Facility | None | $123.03 | $229.09 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $257.04 | Professional | None | $75.86 | $114.82 | $257.04 |
Emblem Health Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $302.00 | Facility | None | $72.44 | $91.20 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $223.87 | Professional | None | $107.15 | $147.91 | $223.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $154.88 | Professional | None | $66.07 | $114.82 | $154.88 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | None | $109.65 | $109.65 | $151.36 |
MVP Health Care Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $223.87 | Professional | None | $85.11 | $85.11 | $223.87 |
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 $63.10 Median $97.72 Typical High $199.53 | Professional | None | $63.10 | $97.72 | $199.53 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $107.15 Typical High $208.93 | Facility | None | $52.48 | $107.15 | $208.93 |
Univera Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $154.88 | Professional | None | $66.07 | $107.15 | $154.88 |
18 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 $38.02 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $38.02 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $22.39 | Professional | 53 · Discontinued | $15.14 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $57.54 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $70.79 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $53.70 | $70.79 | $79.43 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $104.71 Typical High $147.91 | Professional | 54 · Surgery only | $60.26 | $104.71 | $147.91 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.48 Typical High $16.60 | Professional | 55 · Aftercare only | $6.61 | $11.48 | $16.60 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.48 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.61 | $11.48 | $16.60 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $91.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $53.70 | $91.20 | $131.83 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $87.10 Typical High $138.04 | Facility | 54 · Surgery only | $46.77 | $87.10 | $138.04 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $5.25 Median $10.23 Typical High $15.49 | Facility | 55 · Aftercare only | $5.25 | $10.23 | $15.49 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.23 Typical High $15.49 | Facility | 56 · Pre-op care only | $5.25 | $10.23 | $15.49 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $83.18 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $41.69 | $83.18 | $123.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $107.15 Typical High $138.04 | Professional | 54 · Surgery only | $60.26 | $107.15 | $138.04 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.75 Typical High $25.12 | Professional | 55 · Aftercare only | $6.61 | $11.75 | $25.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.75 Typical High $25.12 | Professional | 56 · Pre-op care only | $6.61 | $11.75 | $25.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $95.50 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $53.70 | $95.50 | $123.03 |
Where New York sits
The same service costs 3.7 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· 46th of 51
$95.50
AK $324KY $87.10
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.