How much rates vary
Facilitymedian $2,692 · 10th to 90th $490 to $5,012Professionalmedian $288 · 10th to 90th $141 to $407
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 $724.44 Median $4,168.69 Typical High $10,232.93 | Facility | None | $724.44 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $338.84 | Professional | None | $141.25 | $223.87 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $281.84 Median $338.84 Typical High $389.05 | Professional | None | $281.84 | $338.84 | $389.05 |
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 $263.03 Median $263.03 Typical High $457.09 | Professional | None | $263.03 | $263.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $1,778.28 | Facility | None | $398.11 | $741.31 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $457.09 | Professional | None | $147.91 | $251.19 | $457.09 |
Emblem Health Setting Facility Modifier None Typical Low $25.70 Median $208.93 Typical High $758.58 | Facility | None | $25.70 | $208.93 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $741.31 | Professional | None | $295.12 | $426.58 | $741.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $416.87 | Professional | None | $154.88 | $288.40 | $416.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $426.58 | Professional | None | $316.23 | $398.11 | $426.58 |
MVP Health Care Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $416.87 | Professional | None | $63.10 | $63.10 | $416.87 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $4,897.79 | Facility | None | $537.03 | $1,819.70 | $4,897.79 |
United Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $371.54 | Professional | None | $138.04 | $234.42 | $371.54 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $269.15 Typical High $407.38 | Facility | None | $117.49 | $269.15 | $407.38 |
Univera Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $416.87 | Professional | None | $154.88 | $295.12 | $416.87 |
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 $70.79 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $70.79 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $28.18 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $107.15 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $21.38 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $14.13 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $100.00 | $154.88 | $199.53 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $281.84 Typical High $380.19 | Professional | 54 · Surgery only | $151.36 | $281.84 | $380.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $16.98 | $31.62 | $41.69 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $16.98 | $31.62 | $41.69 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $251.19 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $134.90 | $251.19 | $331.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $199.53 Typical High $275.42 | Professional | 53 · Discontinued | $154.88 | $199.53 | $275.42 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $151.36 | $295.12 | $380.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $33.88 Typical High $60.26 | Professional | 55 · Aftercare only | $16.98 | $33.88 | $60.26 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $33.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $16.98 | $33.88 | $60.26 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $275.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $134.90 | $275.42 | $331.13 |
Where New York sits
The same service costs 4.5 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· 24th of 51
$295
AK $741KY $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.