How much rates vary
Facilitymedian $4,571 · 10th to 90th $851 to $12,882Professionalmedian $275 · 10th to 90th $219 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 $338.84 Median $4,168.69 Typical High $9,120.11 | Facility | None | $338.84 | $4,168.69 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $407.38 | Professional | None | $302.00 | $338.84 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $575.44 | Professional | None | $239.88 | $251.19 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,456.54 Typical High $15,848.93 | Facility | None | $1,659.59 | $6,456.54 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $398.11 | Professional | None | $234.42 | $275.42 | $398.11 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,318.26 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $602.56 | Professional | None | $218.78 | $223.87 | $602.56 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $1,071.52 | Facility | None | $309.03 | $389.05 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $524.81 | Professional | None | $263.03 | $309.03 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $389.05 | Professional | None | $199.53 | $257.04 | $389.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $6,309.57 Typical High $9,549.93 | Facility | None | $1,071.52 | $6,309.57 | $9,549.93 |
MVP Health Care Setting Facility Modifier None Typical Low $302.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $302.00 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | None | $346.74 | $346.74 | $446.68 |
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 $194.98 Median $263.03 Typical High $416.87 | Professional | None | $194.98 | $263.03 | $416.87 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $1,148.15 | Facility | None | $190.55 | $263.03 | $1,148.15 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $389.05 | Professional | None | $199.53 | $263.03 | $389.05 |
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 $151.36 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $60.26 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $234.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $223.87 Typical High $346.74 | Professional | 54 · Surgery only | $144.54 | $223.87 | $346.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.12 Typical High $38.90 | Professional | 55 · Aftercare only | $16.22 | $25.12 | $38.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.39 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.45 | $22.39 | $34.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $309.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $194.98 Typical High $295.12 | Professional | 53 · Discontinued | $151.36 | $194.98 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $229.09 Typical High $346.74 | Professional | 54 · Surgery only | $144.54 | $229.09 | $346.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.70 Typical High $57.54 | Professional | 55 · Aftercare only | $16.22 | $25.70 | $57.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.91 Typical High $52.48 | Professional | 56 · Pre-op care only | $14.45 | $22.91 | $52.48 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $208.93 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $128.82 | $208.93 | $309.03 |
Where New York sits
The same service costs 5.5 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· 47th of 51
$275
AK $1,202UT $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.