How much rates vary
Facilitymedian $2,692 · 10th to 90th $331 to $5,248Professionalmedian $224 · 10th to 90th $132 to $372
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 $245.47 Median $3,548.13 Typical High $8,128.31 | Facility | None | $245.47 | $3,548.13 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $288.40 | Professional | None | $134.90 | $257.04 | $288.40 |
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 $190.55 Median $223.87 Typical High $309.03 | Professional | None | $190.55 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $338.84 Typical High $467.74 | Professional | 50 · Both sides | $288.40 | $338.84 | $467.74 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $354.81 | Professional | None | $186.21 | $186.21 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $436.52 Typical High $1,479.11 | Facility | None | $223.87 | $436.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $512.86 | Professional | None | $123.03 | $229.09 | $512.86 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $147.91 Typical High $501.19 | Facility | None | $34.67 | $147.91 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $436.52 | Professional | None | $218.78 | $288.40 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $309.03 | Professional | None | $131.83 | $229.09 | $309.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $794.33 Typical High $1,047.13 | Facility | None | $218.78 | $794.33 | $1,047.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $467.74 | Professional | None | $194.98 | $363.08 | $467.74 |
MVP Health Care Setting Facility Modifier None Typical Low $144.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $144.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $630.96 | Professional | None | $120.23 | $120.23 | $630.96 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,737.80 Typical High $4,897.79 | Facility | None | $537.03 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $407.38 | Professional | None | $109.65 | $204.17 | $407.38 |
Univera Setting Facility Modifier None Typical Low $89.13 Median $218.78 Typical High $524.81 | Facility | None | $89.13 | $218.78 | $524.81 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $309.03 | Professional | None | $158.49 | $218.78 | $309.03 |
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 $67.61 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $67.61 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $26.92 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $186.21 Typical High $194.98 | Professional | 54 · Surgery only | $100.00 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $19.95 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.49 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $173.78 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $93.33 | $173.78 | $181.97 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $204.17 | $275.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $13.18 | $22.91 | $30.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.18 | $22.91 | $30.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $107.15 | $181.97 | $245.47 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $134.90 | $190.55 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $204.17 | $275.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.91 Typical High $57.54 | Professional | 55 · Aftercare only | $13.18 | $22.91 | $57.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.91 Typical High $57.54 | Professional | 56 · Pre-op care only | $13.18 | $22.91 | $57.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $107.15 | $181.97 | $245.47 |
Where New York sits
The same service costs 3.6 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· 36th of 51
$224
AK $617KY $170
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.