How much rates vary
Facilitymedian $2,630 · 10th to 90th $269 to $5,012Professionalmedian $186 · 10th to 90th $110 to $363
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 $112.20 Median $190.55 Typical High $223.87 | Professional | None | $112.20 | $190.55 | $223.87 |
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 $165.96 Median $194.98 Typical High $331.13 | Professional | None | $165.96 | $194.98 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $295.12 Typical High $501.19 | Professional | 50 · Both sides | $245.47 | $295.12 | $501.19 |
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 $151.36 Median $151.36 Typical High $263.03 | Professional | None | $151.36 | $151.36 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $446.68 | Facility | None | $100.00 | $223.87 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $645.65 | Professional | None | $85.11 | $144.54 | $645.65 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $120.23 Typical High $398.11 | Facility | None | $39.81 | $120.23 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $380.19 | Professional | None | $204.17 | $234.42 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $234.42 | Professional | None | $123.03 | $177.83 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $398.11 | Professional | None | $60.26 | $60.26 | $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 $87.10 Median $162.18 Typical High $446.68 | Professional | None | $87.10 | $162.18 | $446.68 |
Univera Setting Facility Modifier None Typical Low $81.28 Median $169.82 Typical High $302.00 | Facility | None | $81.28 | $169.82 | $302.00 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $223.87 | Professional | None | $123.03 | $169.82 | $223.87 |
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 $56.23 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $22.39 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $144.54 Typical High $165.96 | Professional | 54 · Surgery only | $83.18 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.22 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $134.90 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $77.62 | $134.90 | $154.88 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $223.87 | Professional | 54 · Surgery only | $112.20 | $162.18 | $223.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $17.78 | $25.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $25.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $199.53 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $120.23 Typical High $186.21 | Professional | 53 · Discontinued | $91.20 | $120.23 | $186.21 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $112.20 | $162.18 | $208.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.78 Typical High $36.31 | Professional | 55 · Aftercare only | $12.30 | $17.78 | $36.31 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $36.31 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $186.21 |
Where New York sits
The same service costs 4.5 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
$191
AK $457KY $102
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.