How much rates vary
Facilitymedian $2,630 · 10th to 90th $240 to $5,012Professionalmedian $105 · 10th to 90th $87 to $195
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 $1,318.26 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | None | $102.33 | $117.49 | $117.49 |
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 $89.13 Median $104.71 Typical High $151.36 | Professional | None | $89.13 | $104.71 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $158.49 Typical High $223.87 | Professional | 50 · Both sides | $131.83 | $158.49 | $223.87 |
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 $141.25 Median $141.25 Typical High $162.18 | Professional | None | $141.25 | $141.25 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $331.13 | Facility | None | $100.00 | $162.18 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $257.04 | Professional | None | $91.20 | $104.71 | $257.04 |
Emblem Health Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $426.58 | Facility | None | $112.20 | $199.53 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $245.47 | Professional | None | $147.91 | $147.91 | $245.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $158.49 | Professional | None | $69.18 | $117.49 | $158.49 |
Highmark BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
MVP Health Care Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $331.13 | Professional | None | $120.23 | $123.03 | $331.13 |
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 $74.13 Median $112.20 Typical High $239.88 | Professional | None | $74.13 | $112.20 | $239.88 |
Univera Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $416.87 | Facility | None | $72.44 | $91.20 | $416.87 |
Univera Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $158.49 | Professional | None | $81.28 | $102.33 | $158.49 |
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 $51.29 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $51.29 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $87.10 Typical High $89.13 | Professional | 54 · Surgery only | $77.62 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $17.78 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.23 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $81.28 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $72.44 | $81.28 | $83.18 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $93.33 Typical High $125.89 | Professional | 54 · Surgery only | $54.95 | $93.33 | $125.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $14.45 | $24.55 | $33.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.75 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.92 | $11.75 | $15.85 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $81.28 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $47.86 | $81.28 | $109.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $91.20 | Professional | 53 · Discontinued | $58.88 | $61.66 | $91.20 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $93.33 Typical High $125.89 | Professional | 54 · Surgery only | $54.95 | $93.33 | $125.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $24.55 Typical High $64.57 | Professional | 55 · Aftercare only | $14.45 | $24.55 | $64.57 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.75 Typical High $30.90 | Professional | 56 · Pre-op care only | $6.92 | $11.75 | $30.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $81.28 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $47.86 | $81.28 | $109.65 |
Where New York sits
The same service costs 4.5 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· 46th of 51
$107
AK $427FL $95.50
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.