How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,122 to $10,965Professionalmedian $389 · 10th to 90th $302 to $631
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 $1,513.56 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,513.56 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $537.03 | Professional | None | $407.38 | $446.68 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $645.65 | Professional | None | $316.23 | $371.54 | $645.65 |
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 $478.63 Median $478.63 Typical High $660.69 | Professional | None | $478.63 | $478.63 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,148.15 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $776.25 | Professional | None | $251.19 | $354.81 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $1,258.93 | Facility | None | $331.13 | $407.38 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $954.99 | Professional | None | $562.34 | $562.34 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $602.56 | Professional | None | $302.00 | $389.05 | $602.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $23,442.29 | Facility | None | $3,235.94 | $4,365.16 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $8,128.31 | Facility | None | $1,148.15 | $2,754.23 | $8,128.31 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $588.84 | Professional | None | $251.19 | $371.54 | $588.84 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $1,348.96 | Facility | None | $208.93 | $331.13 | $1,348.96 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $602.56 | Professional | None | $302.00 | $389.05 | $602.56 |
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 $204.17 Median $213.80 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $380.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $218.78 | $407.38 | $537.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $44.67 Typical High $60.26 | Professional | 55 · Aftercare only | $24.55 | $44.67 | $60.26 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $40.74 Typical High $53.70 | Professional | 56 · Pre-op care only | $21.88 | $40.74 | $53.70 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $199.53 | $363.08 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $309.03 Typical High $446.68 | Professional | 53 · Discontinued | $239.88 | $309.03 | $446.68 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $218.78 | $407.38 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $44.67 Typical High $87.10 | Professional | 55 · Aftercare only | $24.55 | $44.67 | $87.10 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $40.74 Typical High $79.43 | Professional | 56 · Pre-op care only | $21.88 | $40.74 | $79.43 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $199.53 | $363.08 | $489.78 |
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· 46th of 51
$389
AK $1,318NJ $331
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.