How much rates vary
Facilitymedian $3,090 · 10th to 90th $245 to $7,413Professionalmedian $132 · 10th to 90th $95 to $263
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 $141.25 Median $3,548.13 Typical High $9,332.54 | Facility | None | $141.25 | $3,548.13 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $218.78 | Professional | None | $109.65 | $141.25 | $218.78 |
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 $117.49 Median $141.25 Typical High $239.88 | Professional | None | $117.49 | $141.25 | $239.88 |
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 $131.83 Median $131.83 Typical High $190.55 | Professional | None | $131.83 | $131.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $245.47 Typical High $1,778.28 | Facility | None | $128.82 | $245.47 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $457.09 | Professional | None | $81.28 | $141.25 | $457.09 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $338.84 | Facility | None | $50.12 | $102.33 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $281.84 | Professional | None | $158.49 | $173.78 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $199.53 | Professional | None | $93.33 | $131.83 | $199.53 |
Highmark BCBS Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $131.83 | Facility | None | $120.23 | $125.89 | $131.83 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $309.03 | Professional | None | $104.71 | $104.71 | $309.03 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $316.23 | Professional | None | $70.79 | $117.49 | $316.23 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $123.03 Typical High $288.40 | Facility | None | $56.23 | $123.03 | $288.40 |
Univera Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $199.53 | Professional | None | $93.33 | $123.03 | $199.53 |
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 $54.95 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $54.95 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $21.88 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $81.28 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $16.60 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.96 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $89.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $75.86 | $89.13 | $123.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $120.23 Typical High $186.21 | Professional | 54 · Surgery only | $85.11 | $120.23 | $186.21 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $20.89 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $20.89 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $20.89 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $107.15 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $75.86 | $107.15 | $165.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $138.04 | Professional | 53 · Discontinued | $63.10 | $83.18 | $138.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $120.23 Typical High $181.97 | Professional | 54 · Surgery only | $85.11 | $120.23 | $181.97 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $27.54 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $27.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $27.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $75.86 | $107.15 | $162.18 |
Where New York sits
The same service costs 3.5 times more in Wisconsin 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· 35th of 51
$141
WI $398KY $115
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.