How much rates vary
Facilitymedian $3,162 · 10th to 90th $724 to $7,413Professionalmedian $427 · 10th to 90th $282 to $724
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 $457.09 Median $3,981.07 Typical High $8,128.31 | Facility | None | $457.09 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $602.56 | Professional | None | $316.23 | $478.63 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $363.08 Median $426.58 Typical High $588.84 | Professional | None | $363.08 | $426.58 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | 50 · Both sides | $537.03 | $630.96 | $870.96 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $660.69 | Professional | None | $436.52 | $436.52 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $2,570.40 | Facility | None | $912.01 | $1,584.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $977.24 | Professional | None | $281.84 | $426.58 | $977.24 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $338.84 Typical High $1,148.15 | Facility | None | $64.57 | $338.84 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $831.76 | Professional | None | $416.87 | $549.54 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $602.56 | Professional | None | $257.04 | $436.52 | $602.56 |
Fidelis Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $346.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $1,174.90 | Professional | None | $173.78 | $173.78 | $1,174.90 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $831.76 | Professional | None | $257.04 | $407.38 | $831.76 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $416.87 Typical High $1,230.27 | Facility | None | $208.93 | $416.87 | $1,230.27 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $602.56 | Professional | None | $302.00 | $416.87 | $602.56 |
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 $158.49 Median $234.42 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $93.33 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $234.42 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $70.79 Typical High $72.44 | Professional | 55 · Aftercare only | $46.77 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $46.77 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $331.13 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $218.78 | $331.13 | $338.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $204.17 | $346.74 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $91.20 Typical High $125.89 | Professional | 55 · Aftercare only | $53.70 | $91.20 | $125.89 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $43.65 Typical High $60.26 | Professional | 56 · Pre-op care only | $25.70 | $43.65 | $60.26 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $302.00 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $177.83 | $302.00 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $354.81 | Professional | 53 · Discontinued | $245.47 | $251.19 | $354.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $204.17 | $346.74 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $91.20 Typical High $234.42 | Professional | 55 · Aftercare only | $53.70 | $91.20 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $43.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $25.70 | $43.65 | $112.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $302.00 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $177.83 | $302.00 | $416.87 |
Where New York sits
The same service costs 4.9 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· 40th of 51
$427
AK $1,413UT $288
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.