How much rates vary
Facilitymedian $2,344 · 10th to 90th $182 to $4,898Professionalmedian $191 · 10th to 90th $115 to $331
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 $112.20 Median $2,754.23 Typical High $7,762.47 | Facility | None | $112.20 | $2,754.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $302.00 | Professional | None | $97.72 | $151.36 | $302.00 |
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 $162.18 Median $204.17 Typical High $295.12 | Professional | None | $162.18 | $204.17 | $295.12 |
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 $154.88 Median $154.88 Typical High $251.19 | Professional | None | $154.88 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $288.40 Typical High $1,479.11 | Facility | None | $154.88 | $288.40 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $537.03 | Professional | None | $114.82 | $194.98 | $537.03 |
Emblem Health Setting Facility Modifier None Typical Low $69.18 Median $120.23 Typical High $389.05 | Facility | None | $69.18 | $120.23 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $371.54 | Professional | None | $199.53 | $229.09 | $371.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $257.04 | Professional | None | $123.03 | $165.96 | $257.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $426.58 | Facility | None | $213.80 | $338.84 | $426.58 |
MVP Health Care Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
MVP Health Care Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $389.05 | Professional | None | $199.53 | $199.53 | $389.05 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $363.08 | Professional | None | $95.50 | $169.82 | $363.08 |
Univera Setting Facility Modifier None Typical Low $79.43 Median $165.96 Typical High $316.23 | Facility | None | $79.43 | $165.96 | $316.23 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $239.88 | Professional | None | $123.03 | $165.96 | $239.88 |
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 $48.98 Median $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $48.98 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $19.50 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $112.20 Typical High $123.03 | Professional | 54 · Surgery only | $72.44 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $14.45 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.77 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $104.71 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $67.61 | $104.71 | $114.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $154.88 Typical High $239.88 | Professional | 54 · Surgery only | $109.65 | $154.88 | $239.88 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $26.92 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $26.92 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $26.92 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $138.04 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $97.72 | $138.04 | $213.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $186.21 | Professional | 53 · Discontinued | $79.43 | $104.71 | $186.21 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $154.88 Typical High $234.42 | Professional | 54 · Surgery only | $109.65 | $154.88 | $234.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $35.48 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $35.48 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $35.48 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $35.48 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $138.04 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $97.72 | $138.04 | $208.93 |
Where New York sits
The same service costs 3.6 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· 20th of 51
$195
AK $457KY $126
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.