How much rates vary
Facilitymedian $3,090 · 10th to 90th $437 to $7,413Professionalmedian $269 · 10th to 90th $151 to $389
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 $398.11 Median $4,677.35 Typical High $8,128.31 | Facility | None | $398.11 | $4,677.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $389.05 | Professional | None | $186.21 | $295.12 | $389.05 |
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 $251.19 Median $295.12 Typical High $407.38 | Professional | None | $251.19 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $436.52 Typical High $588.84 | Professional | 50 · Both sides | $371.54 | $436.52 | $588.84 |
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 $218.78 Median $218.78 Typical High $407.38 | Professional | None | $218.78 | $218.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $1,479.11 | Facility | None | $275.42 | $467.74 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $467.74 | Professional | None | $125.89 | $234.42 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $524.81 | Facility | None | $95.50 | $154.88 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $501.19 | Professional | None | $257.04 | $331.13 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $354.81 | Professional | None | $158.49 | $234.42 | $354.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $199.53 Typical High $363.08 | Facility | None | $83.18 | $199.53 | $363.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $354.81 | Professional | None | $186.21 | $338.84 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $3,235.94 Typical High $4,365.16 | Facility | None | $147.91 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $398.11 | Professional | None | $151.36 | $151.36 | $398.11 |
United Setting Facility Modifier None Typical Low $776.25 Median $2,137.96 Typical High $6,309.57 | Facility | None | $776.25 | $2,137.96 | $6,309.57 |
United Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $363.08 | Professional | None | $120.23 | $229.09 | $363.08 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $512.86 | Facility | None | $151.36 | $257.04 | $512.86 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $354.81 | Professional | None | $158.49 | $234.42 | $354.81 |
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 $93.33 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $93.33 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $141.25 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $28.18 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $239.88 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 79 · Unrelated procedure after surgery | $316.23 | $316.23 | $316.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $239.88 | $316.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.30 Typical High $35.48 | Professional | 55 · Aftercare only | $22.39 | $26.30 | $35.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $26.30 | $35.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $213.80 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $213.80 | $281.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $239.88 | Professional | 53 · Discontinued | $141.25 | $169.82 | $239.88 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $239.88 | $316.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.30 Typical High $57.54 | Professional | 55 · Aftercare only | $22.39 | $26.30 | $57.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.30 Typical High $57.54 | Professional | 56 · Pre-op care only | $22.39 | $26.30 | $57.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $213.80 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $213.80 | $281.84 |
Where New York sits
The same service costs 3.8 times more in Wyoming 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· 33rd of 51
$275
WY $741KY $195
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.