How much rates vary
Facilitymedian $2,570 · 10th to 90th $398 to $5,012Professionalmedian $275 · 10th to 90th $155 to $380
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 $302.00 Median $3,467.37 Typical High $7,762.47 | Facility | None | $302.00 | $3,467.37 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $380.19 | Professional | None | $218.78 | $302.00 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $354.81 | Professional | None | $190.55 | $302.00 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $407.38 | Professional | None | $263.03 | $309.03 | $407.38 |
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 $275.42 Median $275.42 Typical High $416.87 | Professional | None | $275.42 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $1,479.11 | Facility | None | $331.13 | $549.54 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $467.74 | Professional | None | $154.88 | $229.09 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $776.25 | Facility | None | $102.33 | $223.87 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $660.69 | Professional | None | $263.03 | $389.05 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $371.54 | Professional | None | $190.55 | $263.03 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $112.20 Median $416.87 Typical High $2,951.21 | Facility | None | $112.20 | $416.87 | $2,951.21 |
Highmark BCBS Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $676.08 | Professional | None | $363.08 | $389.05 | $676.08 |
MVP Health Care Setting Facility Modifier None Typical Low $177.83 Median $3,235.94 Typical High $4,365.16 | Facility | None | $177.83 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $398.11 | Professional | None | $104.71 | $104.71 | $398.11 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $4,897.79 | Facility | None | $524.81 | $1,778.28 | $4,897.79 |
United Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $354.81 | Professional | None | $147.91 | $229.09 | $354.81 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $549.54 | Facility | None | $125.89 | $263.03 | $549.54 |
Univera Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $371.54 | Professional | None | $190.55 | $263.03 | $371.54 |
16 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 $109.65 Median $125.89 Typical High $154.88 | Professional | 52 · Reduced service | $109.65 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $43.65 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $165.96 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $33.11 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $213.80 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $138.04 | $263.03 | $338.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $15.49 | $28.84 | $38.02 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $15.49 | $28.84 | $38.02 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $234.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $123.03 | $234.42 | $302.00 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 59 · Distinct service | $346.74 | $346.74 | $346.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $181.97 Typical High $257.04 | Professional | 53 · Discontinued | $141.25 | $181.97 | $257.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $138.04 | $263.03 | $338.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $28.84 Typical High $60.26 | Professional | 55 · Aftercare only | $15.49 | $28.84 | $60.26 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.84 Typical High $60.26 | Professional | 56 · Pre-op care only | $15.49 | $28.84 | $60.26 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $234.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $123.03 | $234.42 | $295.12 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 32nd of 51
$275
AK $776KY $204
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.