How much rates vary
Facilitymedian $2,570 · 10th to 90th $380 to $5,012Professionalmedian $324 · 10th to 90th $269 to $575
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 $380.19 Median $3,890.45 Typical High $8,128.31 | Facility | None | $380.19 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $398.11 | Professional | None | $309.03 | $338.84 | $398.11 |
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 $275.42 Median $323.59 Typical High $457.09 | Professional | None | $275.42 | $323.59 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $478.63 Typical High $660.69 | Professional | 50 · Both sides | $407.38 | $478.63 | $660.69 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | None | $436.52 | $436.52 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $1,479.11 | Facility | None | $186.21 | $380.19 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $741.31 | Professional | None | $302.00 | $323.59 | $741.31 |
Emblem Health Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $1,258.93 | Facility | None | $245.47 | $398.11 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $676.08 | Professional | None | $309.03 | $446.68 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $457.09 | Professional | None | $194.98 | $338.84 | $457.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $812.83 | Professional | None | $398.11 | $457.09 | $812.83 |
MVP Health Care Setting Facility Modifier None Typical Low $295.12 Median $3,235.94 Typical High $4,365.16 | Facility | None | $295.12 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $831.76 | Professional | None | $309.03 | $309.03 | $831.76 |
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 $229.09 Median $338.84 Typical High $758.58 | Professional | None | $229.09 | $338.84 | $758.58 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $1,318.26 | Facility | None | $213.80 | $309.03 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $457.09 | Professional | None | $234.42 | $309.03 | $457.09 |
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 $154.88 Median $169.82 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $234.42 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $218.78 | $234.42 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $269.15 Typical High $389.05 | Professional | 54 · Surgery only | $154.88 | $269.15 | $389.05 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $41.69 | $72.44 | $102.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $19.50 | $33.88 | $48.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $234.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $134.90 | $234.42 | $338.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $257.04 | Professional | 53 · Discontinued | $173.78 | $177.83 | $257.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $154.88 | $281.84 | $363.08 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $75.86 Typical High $177.83 | Professional | 55 · Aftercare only | $41.69 | $75.86 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $35.48 Typical High $85.11 | Professional | 56 · Pre-op care only | $19.50 | $35.48 | $85.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $245.47 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $134.90 | $245.47 | $316.23 |
Where New York sits
The same service costs 5.9 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· 42nd of 51
$324
AK $1,288UT $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.