How much rates vary
Facilitymedian $3,548 · 10th to 90th $912 to $8,318Professionalmedian $372 · 10th to 90th $282 to $1,000
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 $457.09 Median $5,248.07 Typical High $11,220.18 | Facility | None | $457.09 | $5,248.07 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $1,000.00 | Professional | None | $363.08 | $457.09 | $1,000.00 |
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 $281.84 Median $331.13 Typical High $812.83 | Professional | None | $281.84 | $331.13 | $812.83 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | None | $524.81 | $524.81 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,513.56 | Professional | None | $467.74 | $524.81 | $1,513.56 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $794.33 Typical High $1,621.81 | Facility | None | $416.87 | $794.33 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $912.01 | Professional | None | $478.63 | $549.54 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $602.56 | Professional | None | $309.03 | $398.11 | $602.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $6,165.95 | Facility | None | $1,995.26 | $3,162.28 | $6,165.95 |
MVP Health Care Setting Facility Modifier None Typical Low $478.63 Median $3,235.94 Typical High $4,365.16 | Facility | None | $478.63 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,071.52 | Professional | None | $562.34 | $1,000.00 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $9,120.11 | Facility | None | $1,122.02 | $2,754.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $1,047.13 | Professional | None | $316.23 | $467.74 | $1,047.13 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $1,174.90 | Facility | None | $323.59 | $407.38 | $1,174.90 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $562.34 | Professional | None | $309.03 | $398.11 | $562.34 |
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 $181.97 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $181.97 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $323.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $239.88 | $309.03 | $478.63 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $144.54 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $107.15 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $371.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $281.84 Typical High $436.52 | Professional | 53 · Discontinued | $204.17 | $281.84 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $467.74 | Professional | 54 · Surgery only | $239.88 | $309.03 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $190.55 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $141.25 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $407.38 |
Where New York sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 47th of 51
$407
AK $1,380UT $324
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.