How much rates vary
Facilitymedian $2,570 · 10th to 90th $355 to $5,012Professionalmedian $240 · 10th to 90th $195 to $427
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 $630.96 Median $4,168.69 Typical High $8,128.31 | Facility | None | $630.96 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | None | $229.09 | $257.04 | $269.15 |
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 $204.17 Median $239.88 Typical High $331.13 | Professional | None | $204.17 | $239.88 | $331.13 |
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 $323.59 Median $323.59 Typical High $363.08 | Professional | None | $323.59 | $323.59 | $363.08 |
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 $213.80 Median $239.88 Typical High $562.34 | Professional | None | $213.80 | $239.88 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $933.25 | Facility | None | $257.04 | $302.00 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $501.19 | Professional | None | $229.09 | $331.13 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $354.81 | Professional | None | $151.36 | $263.03 | $354.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $257.04 Median $3,235.94 Typical High $4,365.16 | Facility | None | $257.04 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $645.65 | Professional | None | $263.03 | $281.84 | $645.65 |
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 $165.96 Median $251.19 Typical High $549.54 | Professional | None | $165.96 | $251.19 | $549.54 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $1,000.00 | Facility | None | $158.49 | $229.09 | $1,000.00 |
Univera Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $354.81 | Professional | None | $177.83 | $229.09 | $354.81 |
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 $114.82 Median $128.82 Typical High $134.90 | Professional | 52 · Reduced service | $114.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $173.78 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $186.21 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $208.93 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $208.93 | $275.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $54.95 Typical High $74.13 | Professional | 55 · Aftercare only | $31.62 | $54.95 | $74.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.14 | $26.30 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $104.71 | $181.97 | $245.47 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $131.83 | $138.04 | $194.98 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $208.93 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $208.93 | $275.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $54.95 Typical High $138.04 | Professional | 55 · Aftercare only | $31.62 | $54.95 | $138.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $26.30 Typical High $74.13 | Professional | 56 · Pre-op care only | $15.14 | $26.30 | $74.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $104.71 | $181.97 | $245.47 |
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· 46th of 51
$240
AK $955UT $186
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.