How much rates vary
Facilitymedian $3,090 · 10th to 90th $525 to $7,244Professionalmedian $178 · 10th to 90th $85 to $282
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 $151.36 Median $3,548.13 Typical High $7,762.47 | Facility | None | $151.36 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $263.03 | Professional | None | $125.89 | $190.55 | $263.03 |
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 $158.49 Median $186.21 Typical High $309.03 | Professional | None | $158.49 | $186.21 | $309.03 |
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 $154.88 Median $154.88 Typical High $316.23 | Professional | None | $154.88 | $154.88 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,290.87 | Facility | None | $776.25 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $354.81 | Professional | None | $85.11 | $169.82 | $354.81 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $120.23 Typical High $398.11 | Facility | None | $34.67 | $120.23 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $436.52 | Professional | None | $199.53 | $213.80 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $281.84 | Professional | None | $141.25 | $199.53 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,951.21 | Facility | None | $1,905.46 | $1,905.46 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
MVP Health Care Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $389.05 | Professional | None | $75.86 | $75.86 | $389.05 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $251.19 | Professional | None | $85.11 | $151.36 | $251.19 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $199.53 Typical High $323.59 | Facility | None | $70.79 | $199.53 | $323.59 |
Univera Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $281.84 | Professional | None | $141.25 | $199.53 | $281.84 |
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 $63.10 Median $93.33 Typical High $120.23 | Professional | 52 · Reduced service | $63.10 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $47.86 | Professional | 53 · Discontinued | $25.70 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $95.50 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $19.05 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.62 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.59 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $128.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $89.13 | $128.82 | $165.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $102.33 | $181.97 | $257.04 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $11.48 | $19.95 | $28.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $28.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $162.18 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $91.20 | $162.18 | $223.87 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $138.04 Typical High $204.17 | Professional | 53 · Discontinued | $107.15 | $138.04 | $204.17 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $102.33 | $181.97 | $257.04 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $19.95 Typical High $40.74 | Professional | 55 · Aftercare only | $11.48 | $19.95 | $40.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $40.74 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $40.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $162.18 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $91.20 | $162.18 | $223.87 |
Where New York sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 36th of 51
$178
AK $447DC $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.