How much rates vary
Facilitymedian $3,162 · 10th to 90th $324 to $7,413Professionalmedian $141 · 10th to 90th $98 to $204
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 $213.80 Median $4,168.69 Typical High $8,128.31 | Facility | None | $213.80 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $177.83 | Professional | None | $128.82 | $154.88 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $144.54 Typical High $269.15 | Professional | None | $48.98 | $144.54 | $269.15 |
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 $131.83 Median $154.88 Typical High $204.17 | Professional | None | $131.83 | $154.88 | $204.17 |
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 $151.36 Median $151.36 Typical High $208.93 | Professional | None | $151.36 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $257.04 Typical High $1,479.11 | Facility | None | $138.04 | $257.04 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $263.03 | Professional | None | $83.18 | $114.82 | $263.03 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $120.23 Typical High $398.11 | Facility | None | $54.95 | $120.23 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $309.03 | Professional | None | $134.90 | $177.83 | $309.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $194.98 | Professional | None | $97.72 | $134.90 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
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 $100.00 Median $100.00 Typical High $281.84 | Professional | None | $100.00 | $100.00 | $281.84 |
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 $83.18 Median $117.49 Typical High $190.55 | Professional | None | $83.18 | $117.49 | $190.55 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $134.90 Typical High $389.05 | Facility | None | $70.79 | $134.90 | $389.05 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $194.98 | Professional | None | $97.72 | $134.90 | $194.98 |
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 $64.57 Median $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $64.57 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $123.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $128.82 Typical High $177.83 | Professional | 54 · Surgery only | $70.79 | $128.82 | $177.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.45 Typical High $19.50 | Professional | 55 · Aftercare only | $7.94 | $14.45 | $19.50 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $14.45 Typical High $19.50 | Professional | 56 · Pre-op care only | $7.94 | $14.45 | $19.50 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $114.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $63.10 | $114.82 | $154.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $97.72 Typical High $138.04 | Professional | 53 · Discontinued | $75.86 | $97.72 | $138.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $128.82 Typical High $177.83 | Professional | 54 · Surgery only | $70.79 | $128.82 | $177.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.45 Typical High $28.18 | Professional | 55 · Aftercare only | $7.94 | $14.45 | $28.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $14.45 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.94 | $14.45 | $28.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $114.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $63.10 | $114.82 | $154.88 |
Where New York sits
The same service costs 4.0 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· 38th of 51
$141
AK $437NJ $110
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.