How much rates vary
Facilitymedian $2,630 · 10th to 90th $363 to $5,012Professionalmedian $224 · 10th to 90th $107 to $324
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 $1,318.26 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $295.12 | Professional | None | $158.49 | $239.88 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $213.80 Median $251.19 Typical High $338.84 | Professional | None | $213.80 | $251.19 | $338.84 |
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 $190.55 Median $190.55 Typical High $346.74 | Professional | None | $190.55 | $190.55 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $1,479.11 | Facility | None | $269.15 | $457.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $380.19 | Professional | None | $107.15 | $186.21 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $154.88 Typical High $512.86 | Facility | None | $50.12 | $154.88 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $549.54 | Professional | None | $218.78 | $323.59 | $549.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $323.59 | Professional | None | $162.18 | $218.78 | $323.59 |
Highmark BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $134.90 Median $3,235.94 Typical High $4,365.16 | Facility | None | $134.90 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $398.11 | Professional | None | $44.67 | $44.67 | $398.11 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $295.12 | Professional | None | $107.15 | $186.21 | $295.12 |
Univera Setting Facility Modifier None Typical Low $89.13 Median $218.78 Typical High $380.19 | Facility | None | $89.13 | $218.78 | $380.19 |
Univera Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $316.23 | Professional | None | $162.18 | $218.78 | $316.23 |
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 $79.43 Median $102.33 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $40.74 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $194.98 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $223.87 Typical High $288.40 | Professional | 54 · Surgery only | $117.49 | $223.87 | $288.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $24.55 Typical High $32.36 | Professional | 55 · Aftercare only | $13.18 | $24.55 | $32.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $13.18 | $24.55 | $32.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $194.98 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $104.71 | $194.98 | $257.04 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $158.49 Typical High $223.87 | Professional | 53 · Discontinued | $123.03 | $158.49 | $223.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $117.49 | $218.78 | $288.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $24.55 Typical High $47.86 | Professional | 55 · Aftercare only | $13.18 | $24.55 | $47.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $24.55 Typical High $47.86 | Professional | 56 · Pre-op care only | $13.18 | $24.55 | $47.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $194.98 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $104.71 | $194.98 | $257.04 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 33rd of 51
$224
AK $562DC $162
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.