How much rates vary
Facilitymedian $2,630 · 10th to 90th $245 to $5,129Professionalmedian $145 · 10th to 90th $107 to $245
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 $323.59 Median $3,981.07 Typical High $9,332.54 | Facility | None | $323.59 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $234.42 | Professional | None | $138.04 | $154.88 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $147.91 | Professional | None | $125.89 | $141.25 | $147.91 |
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 $125.89 Median $147.91 Typical High $177.83 | Professional | None | $125.89 | $147.91 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $218.78 Typical High $263.03 | Professional | 50 · Both sides | $186.21 | $218.78 | $263.03 |
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 $165.96 Median $165.96 Typical High $190.55 | Professional | None | $165.96 | $165.96 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $223.87 Typical High $1,479.11 | Facility | None | $120.23 | $223.87 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $295.12 | Professional | None | $104.71 | $120.23 | $295.12 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $134.90 Typical High $426.58 | Facility | None | $100.00 | $134.90 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $257.04 | Professional | None | $123.03 | $169.82 | $257.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $165.96 | Professional | None | $104.71 | $134.90 | $165.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $1,513.56 | Facility | None | $446.68 | $446.68 | $1,513.56 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $25,118.86 Typical High $36,307.81 | Facility | None | $138.04 | $25,118.86 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $398.11 | Professional | None | $138.04 | $204.17 | $398.11 |
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 $83.18 Median $141.25 Typical High $331.13 | Professional | None | $83.18 | $141.25 | $331.13 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $537.03 | Facility | None | $107.15 | $123.03 | $537.03 |
Univera Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $165.96 | Professional | None | $104.71 | $134.90 | $165.96 |
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 $69.18 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $27.54 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | 54 · Surgery only | $104.71 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $20.89 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.80 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $107.15 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $97.72 | $107.15 | $109.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $93.33 | $120.23 | $158.49 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $17.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $17.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $107.15 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $83.18 | $107.15 | $141.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $114.82 | Professional | 53 · Discontinued | $69.18 | $74.13 | $114.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $93.33 | $120.23 | $147.91 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $33.88 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $33.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $33.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $107.15 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $83.18 | $107.15 | $131.83 |
Where New York sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 38th of 51
$148
AK $490FL $117
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.