How much rates vary
Facilitymedian $2,570 · 10th to 90th $126 to $5,129Professionalmedian $89 · 10th to 90th $65 to $145
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 $104.71 Median $3,890.45 Typical High $8,317.64 | Facility | None | $104.71 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $102.33 | Professional | None | $75.86 | $91.20 | $102.33 |
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 $77.62 Median $91.20 Typical High $107.15 | Professional | None | $77.62 | $91.20 | $107.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $162.18 | Professional | 50 · Both sides | $117.49 | $138.04 | $162.18 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $223.87 | Facility | None | $63.10 | $102.33 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $190.55 | Professional | None | $54.95 | $74.13 | $190.55 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $239.88 | Facility | None | $44.67 | $72.44 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $165.96 | Professional | None | $79.43 | $107.15 | $165.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $117.49 | Professional | None | $70.79 | $87.10 | $117.49 |
Highmark BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $25,118.86 Typical High $36,307.81 | Facility | None | $75.86 | $25,118.86 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $190.55 | Professional | None | $89.13 | $89.13 | $190.55 |
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 $48.98 Median $91.20 Typical High $177.83 | Professional | None | $48.98 | $91.20 | $177.83 |
Univera Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $229.09 | Facility | None | $61.66 | $79.43 | $229.09 |
Univera Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $117.49 | Professional | None | $70.79 | $79.43 | $117.49 |
10 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 54 · Surgery only Typical Low $57.54 Median $66.07 Typical High $72.44 | Professional | 54 · Surgery only | $57.54 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $61.66 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $53.70 | $61.66 | $67.61 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $77.62 Typical High $104.71 | Professional | 54 · Surgery only | $63.10 | $77.62 | $104.71 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.71 Typical High $11.75 | Professional | 55 · Aftercare only | $7.08 | $8.71 | $11.75 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.71 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.08 | $8.71 | $11.75 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $56.23 | $69.18 | $93.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $77.62 Typical High $104.71 | Professional | 54 · Surgery only | $63.10 | $77.62 | $104.71 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.71 Typical High $22.39 | Professional | 55 · Aftercare only | $7.08 | $8.71 | $22.39 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.71 Typical High $22.39 | Professional | 56 · Pre-op care only | $7.08 | $8.71 | $22.39 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $56.23 | $69.18 | $93.33 |
Where New York sits
The same service costs 3.9 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· 35th of 51
$91.20
AK $269FL $69.18
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.