How much rates vary
Facilitymedian $2,692 · 10th to 90th $479 to $5,370Professionalmedian $316 · 10th to 90th $257 to $513
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 $645.65 Median $4,677.35 Typical High $8,128.31 | Facility | None | $645.65 | $4,677.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $549.54 | Professional | None | $331.13 | $389.05 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $380.19 | Professional | None | $239.88 | $288.40 | $380.19 |
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 $269.15 Median $316.23 Typical High $446.68 | Professional | None | $269.15 | $316.23 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $478.63 Typical High $676.08 | Professional | 50 · Both sides | $407.38 | $478.63 | $676.08 |
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 $436.52 Median $436.52 Typical High $467.74 | Professional | None | $436.52 | $436.52 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $1,737.80 | Facility | None | $416.87 | $707.95 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $691.83 | Professional | None | $245.47 | $269.15 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $1,071.52 | Facility | None | $234.42 | $331.13 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $269.15 | Professional | None | $123.03 | $269.15 | $269.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $660.69 | Professional | None | $165.96 | $323.59 | $660.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $302.00 Median $338.84 Typical High $741.31 | Facility | None | $302.00 | $338.84 | $741.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $891.25 | Professional | None | $288.40 | $389.05 | $891.25 |
MVP Health Care Setting Facility Modifier None Typical Low $281.84 Median $3,235.94 Typical High $4,365.16 | Facility | None | $281.84 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $457.09 | Professional | None | $263.03 | $263.03 | $457.09 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $4,897.79 | Facility | None | $512.86 | $1,659.59 | $4,897.79 |
United Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $489.78 | Professional | None | $234.42 | $316.23 | $489.78 |
Univera Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $1,202.26 | Facility | None | $295.12 | $295.12 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $660.69 | Professional | None | $165.96 | $323.59 | $660.69 |
16 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 $186.21 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $186.21 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $74.13 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $257.04 | $275.42 | $295.12 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $575.44 | Professional | 54 · Surgery only | $213.80 | $269.15 | $575.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $87.10 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $87.10 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $43.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $524.81 |
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $309.03 Median $380.19 Typical High $407.38 | Professional | 79 · Unrelated procedure after surgery | $309.03 | $380.19 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $208.93 Typical High $295.12 | Professional | 53 · Discontinued | $165.96 | $208.93 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $575.44 | Professional | 54 · Surgery only | $213.80 | $269.15 | $575.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $128.82 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $128.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $64.57 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $64.57 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $524.81 |
Where New York sits
The same service costs 5.8 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· 43rd of 51
$324
AK $1,259UT $219
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.