How much rates vary
Facilitymedian $2,754 · 10th to 90th $550 to $5,623Professionalmedian $224 · 10th to 90th $174 to $407
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 $812.83 Median $4,570.88 Typical High $9,772.37 | Facility | None | $812.83 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $302.00 | Professional | None | $223.87 | $263.03 | $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 $186.21 Median $218.78 Typical High $302.00 | Professional | None | $186.21 | $218.78 | $302.00 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,778.28 | Facility | None | $602.56 | $1,122.02 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $549.54 | Professional | None | $169.82 | $229.09 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $218.78 Typical High $724.44 | Facility | None | $75.86 | $218.78 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $489.78 | Professional | None | $239.88 | $323.59 | $489.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $331.13 | Professional | None | $194.98 | $257.04 | $331.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $190.55 Median $4,365.16 Typical High $36,307.81 | Facility | None | $190.55 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $616.60 | Professional | None | $245.47 | $245.47 | $616.60 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $524.81 | Professional | None | $147.91 | $251.19 | $524.81 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $741.31 | Facility | None | $173.78 | $239.88 | $741.31 |
Univera Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $331.13 | Professional | None | $194.98 | $239.88 | $331.13 |
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 $112.20 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $112.20 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $44.67 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $169.82 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $158.49 | $169.82 | $190.55 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $229.09 | $295.12 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.70 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $25.70 | $33.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $33.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $204.17 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $204.17 | $263.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $204.17 | Professional | 53 · Discontinued | $125.89 | $134.90 | $204.17 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $234.42 | $295.12 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $26.30 Typical High $63.10 | Professional | 55 · Aftercare only | $19.50 | $26.30 | $63.10 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $63.10 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $63.10 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $263.03 |
Where New York sits
The same service costs 4.3 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· 40th of 51
$229
AK $912KY $214
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.