How much rates vary
Facilitymedian $2,570 · 10th to 90th $347 to $5,012Professionalmedian $229 · 10th to 90th $178 to $355
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 $616.60 Median $4,168.69 Typical High $8,128.31 | Facility | None | $616.60 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $331.13 | Professional | None | $257.04 | $288.40 | $331.13 |
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 $190.55 Median $223.87 Typical High $331.13 | Professional | None | $190.55 | $223.87 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | 50 · Both sides | $288.40 | $338.84 | $501.19 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | None | $302.00 | $302.00 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $1,479.11 | Facility | None | $186.21 | $354.81 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $489.78 | Professional | None | $177.83 | $199.53 | $489.78 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $758.58 | Facility | None | $186.21 | $234.42 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $457.09 | Professional | None | $218.78 | $302.00 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $316.23 | Professional | None | $123.03 | $208.93 | $316.23 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 50 · Both sides | $891.25 | $891.25 | $891.25 |
MVP Health Care Setting Facility Modifier None Typical Low $199.53 Median $3,235.94 Typical High $4,365.16 | Facility | None | $199.53 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | None | $309.03 | $309.03 | $363.08 |
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 $173.78 Median $234.42 Typical High $354.81 | Professional | None | $173.78 | $234.42 | $354.81 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $707.95 | Facility | None | $208.93 | $218.78 | $707.95 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $316.23 | Professional | None | $123.03 | $213.80 | $316.23 |
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 $128.82 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $204.17 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $213.80 | $288.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $31.62 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $31.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $251.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $158.49 Typical High $213.80 | Professional | 53 · Discontinued | $123.03 | $158.49 | $213.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $213.80 | $288.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $51.29 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $51.29 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $251.19 |
Where New York sits
The same service costs 4.3 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· 43rd of 51
$234
AK $871FL $204
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.