How much rates vary
Facilitymedian $3,162 · 10th to 90th $537 to $7,413Professionalmedian $245 · 10th to 90th $138 to $479
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 $1,122.02 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,122.02 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $363.08 | Professional | None | $138.04 | $245.47 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $446.68 | Professional | None | $223.87 | $269.15 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $398.11 Typical High $676.08 | Professional | 50 · Both sides | $331.13 | $398.11 | $676.08 |
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 $181.97 Median $181.97 Typical High $346.74 | Professional | None | $181.97 | $181.97 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $478.63 Typical High $1,778.28 | Facility | None | $251.19 | $478.63 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $812.83 | Professional | None | $102.33 | $194.98 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $141.25 Typical High $467.74 | Facility | None | $75.86 | $141.25 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $501.19 | Professional | None | $269.15 | $309.03 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $309.03 | Professional | None | $165.96 | $229.09 | $309.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $602.56 | Professional | None | $158.49 | $158.49 | $602.56 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $562.34 | Professional | None | $104.71 | $208.93 | $562.34 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $229.09 Typical High $446.68 | Facility | None | $97.72 | $229.09 | $446.68 |
Univera Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $295.12 | Professional | None | $165.96 | $229.09 | $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 $69.18 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $69.18 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $27.54 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $102.33 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $20.42 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.80 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $95.50 | $169.82 | $208.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $147.91 | $213.80 | $295.12 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $33.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.60 | $23.44 | $33.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $263.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $158.49 Typical High $251.19 | Professional | 53 · Discontinued | $120.23 | $158.49 | $251.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $147.91 | $213.80 | $281.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $47.86 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $47.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.44 Typical High $47.86 | Professional | 56 · Pre-op care only | $16.60 | $23.44 | $47.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $251.19 |
Where New York sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 30th of 51
$251
AK $589KY $138
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.