How much rates vary
Facilitymedian $3,162 · 10th to 90th $741 to $7,413Professionalmedian $275 · 10th to 90th $204 to $417
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 $416.87 Median $4,677.35 Typical High $8,128.31 | Facility | None | $416.87 | $4,677.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | None | $257.04 | $295.12 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $616.60 | Professional | None | $281.84 | $281.84 | $616.60 |
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 $234.42 Median $275.42 Typical High $416.87 | Professional | None | $234.42 | $275.42 | $416.87 |
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 $316.23 Median $316.23 Typical High $426.58 | Professional | None | $316.23 | $316.23 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,445.44 Typical High $2,290.87 | Facility | None | $794.33 | $1,445.44 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $524.81 | Professional | None | $173.78 | $234.42 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $794.33 | Facility | None | $173.78 | $251.19 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $630.96 | Professional | None | $275.42 | $363.08 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $407.38 | Professional | None | $204.17 | $263.03 | $407.38 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,691.53 | Facility | None | $2,041.74 | $2,041.74 | $2,691.53 |
MVP Health Care Setting Facility Modifier None Typical Low $234.42 Median $3,235.94 Typical High $4,365.16 | Facility | None | $234.42 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $457.09 | Professional | None | $275.42 | $275.42 | $457.09 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $389.05 | Professional | None | $169.82 | $245.47 | $389.05 |
Univera Setting Facility Modifier None Typical Low $147.91 Median $275.42 Typical High $616.60 | Facility | None | $147.91 | $275.42 | $616.60 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $407.38 | Professional | None | $204.17 | $275.42 | $407.38 |
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 $131.83 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $263.03 | Professional | 54 · Surgery only | $199.53 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $263.03 Typical High $407.38 | Professional | 54 · Surgery only | $147.91 | $263.03 | $407.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $44.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $29.51 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.60 | $29.51 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $234.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $131.83 | $234.42 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $199.53 Typical High $302.00 | Professional | 53 · Discontinued | $154.88 | $199.53 | $302.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $263.03 Typical High $371.54 | Professional | 54 · Surgery only | $147.91 | $263.03 | $371.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $64.57 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $64.57 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $29.51 Typical High $64.57 | Professional | 56 · Pre-op care only | $16.60 | $29.51 | $64.57 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $234.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $131.83 | $234.42 | $331.13 |
Where New York sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 42nd of 51
$275
AK $933UT $219
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.