How much rates vary
Facilitymedian $3,090 · 10th to 90th $288 to $7,413Professionalmedian $195 · 10th to 90th $132 to $347
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 $162.18 Median $3,548.13 Typical High $7,762.47 | Facility | None | $162.18 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $338.84 | Professional | None | $117.49 | $162.18 | $338.84 |
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 $169.82 Median $208.93 Typical High $309.03 | Professional | None | $169.82 | $208.93 | $309.03 |
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 $181.97 Median $181.97 Typical High $257.04 | Professional | None | $181.97 | $181.97 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $323.59 Typical High $1,778.28 | Facility | None | $173.78 | $323.59 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $549.54 | Professional | None | $138.04 | $199.53 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $69.18 Median $141.25 Typical High $467.74 | Facility | None | $69.18 | $141.25 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $380.19 | Professional | None | $213.80 | $234.42 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $245.47 | Professional | None | $102.33 | $165.96 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,630.78 Typical High $4,168.69 | Facility | None | $2,238.72 | $3,630.78 | $4,168.69 |
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 $151.36 Median $151.36 Typical High $398.11 | Professional | None | $151.36 | $151.36 | $398.11 |
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 $112.20 Median $186.21 Typical High $398.11 | Professional | None | $112.20 | $186.21 | $398.11 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $354.81 | Facility | None | $97.72 | $177.83 | $354.81 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $234.42 | Professional | None | $102.33 | $169.82 | $234.42 |
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 $57.54 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $23.44 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $123.03 Typical High $128.82 | Professional | 54 · Surgery only | $87.10 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $17.38 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $114.82 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $81.28 | $114.82 | $120.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $245.47 | Professional | 54 · Surgery only | $114.82 | $158.49 | $245.47 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $12.88 | $17.78 | $26.92 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.78 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.88 | $17.78 | $26.92 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $141.25 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $102.33 | $141.25 | $213.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $194.98 | Professional | 53 · Discontinued | $83.18 | $109.65 | $194.98 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $223.87 | Professional | 54 · Surgery only | $114.82 | $158.49 | $223.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.78 Typical High $37.15 | Professional | 55 · Aftercare only | $12.88 | $17.78 | $37.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.78 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.88 | $17.78 | $37.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $141.25 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $102.33 | $141.25 | $199.53 |
Where New York sits
The same service costs 3.9 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· 26th of 51
$200
AK $550KY $141
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.