How much rates vary
Facilitymedian $2,570 · 10th to 90th $295 to $5,012Professionalmedian $209 · 10th to 90th $174 to $389
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 $3,715.35 Typical High $8,128.31 | Facility | None | $245.47 | $3,715.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $416.87 | Professional | None | $208.93 | $223.87 | $416.87 |
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 $173.78 Median $208.93 Typical High $288.40 | Professional | None | $173.78 | $208.93 | $288.40 |
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 $288.40 Median $288.40 Typical High $309.03 | Professional | None | $288.40 | $288.40 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $234.42 Typical High $467.74 | Facility | None | $100.00 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $478.63 | Professional | None | $194.98 | $208.93 | $478.63 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $870.96 | Facility | None | $223.87 | $275.42 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $295.12 | Professional | None | $128.82 | $218.78 | $295.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Highmark BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $371.54 | Professional | None | $263.03 | $309.03 | $371.54 |
MVP Health Care Setting Facility Modifier None Typical Low $190.55 Median $3,235.94 Typical High $4,365.16 | Facility | None | $190.55 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $549.54 | Professional | None | $223.87 | $223.87 | $549.54 |
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 $147.91 Median $223.87 Typical High $501.19 | Professional | None | $147.91 | $223.87 | $501.19 |
Univera Setting Facility Modifier None Typical Low $141.25 Median $199.53 Typical High $741.31 | Facility | None | $141.25 | $199.53 | $741.31 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $295.12 | Professional | None | $151.36 | $199.53 | $295.12 |
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 $104.71 Median $112.20 Typical High $114.82 | Professional | 52 · Reduced service | $104.71 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $45.71 | Professional | 53 · Discontinued | $41.69 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 54 · Surgery only | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $154.88 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $144.54 | $154.88 | $162.18 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $173.78 Typical High $251.19 | Professional | 54 · Surgery only | $100.00 | $173.78 | $251.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $46.77 Typical High $66.07 | Professional | 55 · Aftercare only | $26.92 | $46.77 | $66.07 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.88 Typical High $31.62 | Professional | 56 · Pre-op care only | $12.88 | $21.88 | $31.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $151.36 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $87.10 | $151.36 | $218.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $173.78 | Professional | 53 · Discontinued | $112.20 | $114.82 | $173.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $100.00 | $177.83 | $234.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $47.86 Typical High $114.82 | Professional | 55 · Aftercare only | $26.92 | $47.86 | $114.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.39 Typical High $54.95 | Professional | 56 · Pre-op care only | $12.88 | $22.39 | $54.95 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $87.10 | $154.88 | $204.17 |
Where New York sits
The same service costs 5.1 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
$214
AK $871UT $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.