How much rates vary
Facilitymedian $2,630 · 10th to 90th $347 to $5,012Professionalmedian $145 · 10th to 90th $115 to $245
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 $4,265.80 Typical High $8,128.31 | Facility | None | $1,000.00 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $158.49 | Professional | None | $131.83 | $154.88 | $158.49 |
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 $123.03 Median $144.54 Typical High $199.53 | Professional | None | $123.03 | $144.54 | $199.53 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | None | $177.83 | $177.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $407.38 Typical High $1,479.11 | Facility | None | $208.93 | $407.38 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $323.59 | Professional | None | $117.49 | $141.25 | $323.59 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $138.04 Typical High $467.74 | Facility | None | $85.11 | $138.04 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $281.84 | Professional | None | $134.90 | $181.97 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $199.53 | Professional | None | $87.10 | $147.91 | $199.53 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
MVP Health Care Setting Facility Modifier None Typical Low $144.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $144.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $398.11 | Professional | None | $95.50 | $95.50 | $398.11 |
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 $93.33 Median $144.54 Typical High $309.03 | Professional | None | $93.33 | $144.54 | $309.03 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $134.90 Typical High $467.74 | Facility | None | $85.11 | $134.90 | $467.74 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $199.53 | Professional | None | $102.33 | $134.90 | $199.53 |
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 $66.07 Median $77.62 Typical High $79.43 | Professional | 52 · Reduced service | $66.07 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $30.90 Typical High $31.62 | Professional | 53 · Discontinued | $26.30 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $114.82 Typical High $117.49 | Professional | 54 · Surgery only | $97.72 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $19.50 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.18 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $107.15 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $91.20 | $107.15 | $109.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $77.62 | $134.90 | $194.98 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.79 Typical High $21.38 | Professional | 55 · Aftercare only | $8.71 | $14.79 | $21.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.79 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.71 | $14.79 | $21.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $120.23 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $69.18 | $120.23 | $173.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $81.28 | $117.49 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $77.62 | $134.90 | $181.97 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.79 Typical High $37.15 | Professional | 55 · Aftercare only | $8.71 | $14.79 | $37.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.79 Typical High $37.15 | Professional | 56 · Pre-op care only | $8.71 | $14.79 | $37.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $69.18 | $120.23 | $162.18 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 43rd of 51
$145
AK $513DE $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.