How much rates vary
Facilitymedian $3,311 · 10th to 90th $912 to $7,762Professionalmedian $295 · 10th to 90th $240 to $537
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 $954.99 Median $5,248.07 Typical High $9,772.37 | Facility | None | $954.99 | $5,248.07 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $537.03 | Professional | None | $288.40 | $323.59 | $537.03 |
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 $251.19 Median $295.12 Typical High $416.87 | Professional | None | $251.19 | $295.12 | $416.87 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | None | $398.11 | $398.11 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $3,019.95 | Facility | None | $1,047.13 | $1,819.70 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $676.08 | Professional | None | $257.04 | $288.40 | $676.08 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $309.03 Typical High $1,023.29 | Facility | None | $64.57 | $309.03 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $588.84 | Professional | None | $281.84 | $380.19 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $416.87 | Professional | None | $181.97 | $309.03 | $416.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | None | $407.38 | $407.38 | $457.09 |
MVP Health Care Setting Facility Modifier None Typical Low $323.59 Median $3,235.94 Typical High $4,365.16 | Facility | None | $323.59 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $776.25 | Professional | None | $302.00 | $302.00 | $776.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $660.69 | Professional | None | $199.53 | $309.03 | $660.69 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $851.14 | Facility | None | $190.55 | $281.84 | $851.14 |
Univera Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $416.87 | Professional | None | $213.80 | $281.84 | $416.87 |
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 $144.54 Median $162.18 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $57.54 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $213.80 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $43.65 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $32.36 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $199.53 | $229.09 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $144.54 | $245.47 | $331.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $64.57 Typical High $89.13 | Professional | 55 · Aftercare only | $38.02 | $64.57 | $89.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $30.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $18.20 | $30.90 | $41.69 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $125.89 | $213.80 | $288.40 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $245.47 | Professional | 53 · Discontinued | $162.18 | $169.82 | $245.47 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $144.54 | $245.47 | $331.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $64.57 Typical High $169.82 | Professional | 55 · Aftercare only | $38.02 | $64.57 | $169.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $30.90 Typical High $81.28 | Professional | 56 · Pre-op care only | $18.20 | $30.90 | $81.28 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $125.89 | $213.80 | $288.40 |
Where New York sits
The same service costs 6.8 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· 45th of 51
$295
AK $1,288UT $191
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.