How much rates vary
Facilitymedian $3,236 · 10th to 90th $724 to $7,413Professionalmedian $162 · 10th to 90th $91 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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $245.47 | Professional | None | $131.83 | $181.97 | $245.47 |
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 $147.91 Median $173.78 Typical High $239.88 | Professional | None | $147.91 | $173.78 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $263.03 Typical High $363.08 | Professional | 50 · Both sides | $218.78 | $263.03 | $363.08 |
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 $154.88 Median $154.88 Typical High $251.19 | Professional | None | $154.88 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $4,073.80 | Facility | None | $954.99 | $2,089.30 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $288.40 | Professional | None | $87.10 | $144.54 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $407.38 | Facility | None | $102.33 | $125.89 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $323.59 | Professional | None | $158.49 | $208.93 | $323.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $229.09 | Professional | None | $91.20 | $151.36 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $251.19 | Professional | None | $70.79 | $70.79 | $251.19 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,456.54 | Facility | None | $851.14 | $2,290.87 | $6,456.54 |
United Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $229.09 | Professional | None | $89.13 | $144.54 | $229.09 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $309.03 | Facility | None | $107.15 | $158.49 | $309.03 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $229.09 | Professional | None | $91.20 | $158.49 | $229.09 |
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 $66.07 Median $79.43 Typical High $107.15 | Professional | 52 · Reduced service | $66.07 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $42.66 | Professional | 53 · Discontinued | $26.30 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $112.20 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $112.20 | $151.36 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $208.93 | Professional | 54 · Surgery only | $128.82 | $151.36 | $208.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $14.13 | $16.98 | $22.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $16.98 | $22.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $112.20 | $134.90 | $186.21 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $147.91 | Professional | 53 · Discontinued | $87.10 | $109.65 | $147.91 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $208.93 | Professional | 54 · Surgery only | $128.82 | $151.36 | $208.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.98 Typical High $33.88 | Professional | 55 · Aftercare only | $14.13 | $16.98 | $33.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.98 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.13 | $16.98 | $33.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $112.20 | $134.90 | $186.21 |
Where New York sits
The same service costs 4.8 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· 38th of 51
$170
AK $603KY $126
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.