How much rates vary
Facilitymedian $3,311 · 10th to 90th $813 to $7,586Professionalmedian $347 · 10th to 90th $245 to $501
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $426.58 | Professional | None | $331.13 | $354.81 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $331.13 Median $389.05 Typical High $512.86 | Professional | None | $331.13 | $389.05 | $512.86 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,148.15 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $630.96 | Professional | None | $204.17 | $281.84 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $302.00 Typical High $1,023.29 | Facility | None | $263.03 | $302.00 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $758.58 | Professional | None | $331.13 | $436.52 | $758.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $489.78 | Professional | None | $245.47 | $331.13 | $489.78 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $346.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $537.03 | Professional | None | $275.42 | $275.42 | $537.03 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $6,760.83 | Facility | None | $851.14 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $467.74 | Professional | None | $204.17 | $288.40 | $467.74 |
Univera Setting Facility Modifier None Typical Low $169.82 Median $331.13 Typical High $977.24 | Facility | None | $169.82 | $331.13 | $977.24 |
Univera Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $489.78 | Professional | None | $245.47 | $331.13 | $489.78 |
16 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 $165.96 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $302.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $177.83 | $316.23 | $436.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $35.48 Typical High $48.98 | Professional | 55 · Aftercare only | $19.50 | $35.48 | $48.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $31.62 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.78 | $31.62 | $43.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $158.49 | $281.84 | $389.05 |
Highmark BCBS Setting Facility Modifier XS · Separate structure Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | XS · Separate structure | $6,025.60 | $6,025.60 | $6,025.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $239.88 Typical High $363.08 | Professional | 53 · Discontinued | $190.55 | $239.88 | $363.08 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $177.83 | $316.23 | $436.52 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $35.48 Typical High $70.79 | Professional | 55 · Aftercare only | $19.50 | $35.48 | $70.79 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $31.62 Typical High $63.10 | Professional | 56 · Pre-op care only | $17.78 | $31.62 | $63.10 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $158.49 | $281.84 | $389.05 |
Where New York sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 34th of 51
$347
AK $1,072NJ $263
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.