How much rates vary
Facilitymedian $2,630 · 10th to 90th $309 to $5,012Professionalmedian $166 · 10th to 90th $135 to $302
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 $1,000.00 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,000.00 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | None | $151.36 | $177.83 | $186.21 |
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 $141.25 Median $165.96 Typical High $234.42 | Professional | None | $141.25 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | 50 · Both sides | $213.80 | $251.19 | $346.74 |
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 $208.93 Median $208.93 Typical High $251.19 | Professional | None | $208.93 | $208.93 | $251.19 |
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 $141.25 Median $169.82 Typical High $398.11 | Professional | None | $141.25 | $169.82 | $398.11 |
Emblem Health Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $645.65 | Facility | None | $165.96 | $199.53 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $354.81 | Professional | None | $162.18 | $234.42 | $354.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $245.47 | Professional | None | $104.71 | $181.97 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
MVP Health Care Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $446.68 | Professional | None | $120.23 | $120.23 | $446.68 |
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 $114.82 Median $169.82 Typical High $354.81 | Professional | None | $114.82 | $169.82 | $354.81 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $162.18 Typical High $602.56 | Facility | None | $104.71 | $162.18 | $602.56 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $245.47 | Professional | None | $123.03 | $162.18 | $245.47 |
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 $75.86 Median $89.13 Typical High $93.33 | Professional | 52 · Reduced service | $75.86 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $35.48 Typical High $37.15 | Professional | 53 · Discontinued | $30.20 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $131.83 Typical High $141.25 | Professional | 54 · Surgery only | $112.20 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.78 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.14 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $123.03 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $104.71 | $123.03 | $131.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $83.18 | $144.54 | $194.98 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $38.90 Typical High $51.29 | Professional | 55 · Aftercare only | $22.39 | $38.90 | $51.29 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.47 | $18.20 | $24.55 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $72.44 | $125.89 | $169.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $134.90 | Professional | 53 · Discontinued | $91.20 | $95.50 | $134.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $83.18 | $144.54 | $194.98 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $38.90 Typical High $97.72 | Professional | 55 · Aftercare only | $22.39 | $38.90 | $97.72 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $18.20 Typical High $46.77 | Professional | 56 · Pre-op care only | $10.47 | $18.20 | $46.77 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $72.44 | $125.89 | $169.82 |
Where New York sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$166
AK $617FL $135
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.