How much rates vary
Facilitymedian $2,570 · 10th to 90th $295 to $5,012Professionalmedian $195 · 10th to 90th $145 to $288
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 $588.84 Median $3,981.07 Typical High $8,128.31 | Facility | None | $588.84 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $302.00 | Professional | None | $190.55 | $234.42 | $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 $165.96 Median $194.98 Typical High $269.15 | Professional | None | $165.96 | $194.98 | $269.15 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | None | $229.09 | $229.09 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $331.13 Typical High $1,479.11 | Facility | None | $173.78 | $331.13 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $363.08 | Professional | None | $128.82 | $162.18 | $363.08 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $575.44 | Facility | None | $138.04 | $165.96 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $380.19 | Professional | None | $177.83 | $245.47 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $269.15 | Professional | None | $107.15 | $177.83 | $269.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
Highmark BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $154.88 Median $3,235.94 Typical High $4,365.16 | Facility | None | $154.88 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | None | $186.21 | $186.21 | $302.00 |
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 $123.03 Median $181.97 Typical High $295.12 | Professional | None | $123.03 | $181.97 | $295.12 |
Univera Setting Facility Modifier None Typical Low $154.88 Median $177.83 Typical High $537.03 | Facility | None | $154.88 | $177.83 | $537.03 |
Univera Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $269.15 | Professional | None | $107.15 | $177.83 | $269.15 |
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 $97.72 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $97.72 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $38.90 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $147.91 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $169.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $177.83 Typical High $239.88 | Professional | 54 · Surgery only | $147.91 | $177.83 | $239.88 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $26.92 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $26.92 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $213.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $173.78 | Professional | 53 · Discontinued | $102.33 | $128.82 | $173.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $177.83 Typical High $239.88 | Professional | 54 · Surgery only | $147.91 | $177.83 | $239.88 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $39.81 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $39.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $39.81 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $39.81 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $213.80 |
Where New York sits
The same service costs 4.0 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· 40th of 51
$195
AK $661FL $166
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.