How much rates vary
Facilitymedian $3,162 · 10th to 90th $479 to $7,413Professionalmedian $219 · 10th to 90th $123 to $302
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 $588.84 Median $3,981.07 Typical High $8,128.31 | Facility | None | $588.84 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $251.19 | Professional | None | $154.88 | $199.53 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
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 $208.93 Median $245.47 Typical High $323.59 | Professional | None | $208.93 | $245.47 | $323.59 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | None | $181.97 | $181.97 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $1,479.11 | Facility | None | $229.09 | $436.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $380.19 | Professional | None | $100.00 | $177.83 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $489.78 | Facility | None | $125.89 | $151.36 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $467.74 | Professional | None | $208.93 | $269.15 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $302.00 | Professional | None | $151.36 | $213.80 | $302.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $363.08 | Professional | None | $141.25 | $141.25 | $363.08 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,760.83 | Facility | None | $831.76 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $275.42 | Professional | None | $97.72 | $162.18 | $275.42 |
Univera Setting Facility Modifier None Typical Low $83.18 Median $208.93 Typical High $457.09 | Facility | None | $83.18 | $208.93 | $457.09 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $302.00 | Professional | None | $151.36 | $213.80 | $302.00 |
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 $77.62 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $134.90 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $107.15 | $134.90 | $173.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $109.65 | $194.98 | $275.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $12.30 | $21.88 | $30.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $30.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $173.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $173.78 | $245.47 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $147.91 Typical High $229.09 | Professional | 53 · Discontinued | $114.82 | $147.91 | $229.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $109.65 | $194.98 | $275.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $21.88 Typical High $43.65 | Professional | 55 · Aftercare only | $12.30 | $21.88 | $43.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $43.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $173.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $173.78 | $245.47 |
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· 27th of 51
$219
AK $525DC $158
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.