How much rates vary
Facilitymedian $3,467 · 10th to 90th $871 to $7,943Professionalmedian $229 · 10th to 90th $182 to $355
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 $691.83 Median $5,623.41 Typical High $10,715.19 | Facility | None | $691.83 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | None | $257.04 | $281.84 | $281.84 |
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 $190.55 Median $229.09 Typical High $331.13 | Professional | None | $190.55 | $229.09 | $331.13 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,348.96 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $524.81 | Professional | None | $181.97 | $186.21 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $323.59 Typical High $933.25 | Facility | None | $263.03 | $323.59 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $457.09 | Professional | None | $218.78 | $263.03 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $323.59 | Professional | None | $169.82 | $218.78 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
MVP Health Care Setting Facility Modifier None Typical Low $257.04 Median $3,235.94 Typical High $4,365.16 | Facility | None | $257.04 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | None | $354.81 | $354.81 | $398.11 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,148.15 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $346.74 | Professional | None | $165.96 | $218.78 | $346.74 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $977.24 | Facility | None | $158.49 | $218.78 | $977.24 |
Univera Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $323.59 | Professional | None | $169.82 | $218.78 | $323.59 |
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 $128.82 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $51.29 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $194.98 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $190.55 Typical High $295.12 | Professional | 54 · Surgery only | $123.03 | $190.55 | $295.12 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $32.36 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $32.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.05 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.30 | $19.05 | $29.51 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $173.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $109.65 | $173.78 | $263.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $162.18 Typical High $245.47 | Professional | 53 · Discontinued | $125.89 | $162.18 | $245.47 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $123.03 | $194.98 | $295.12 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.88 Typical High $48.98 | Professional | 55 · Aftercare only | $13.49 | $21.88 | $48.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.50 Typical High $43.65 | Professional | 56 · Pre-op care only | $12.30 | $19.50 | $43.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $173.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $109.65 | $173.78 | $263.03 |
Where New York sits
The same service costs 6.0 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
$229
AK $1,000UT $166
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.