How much rates vary
Facilitymedian $3,236 · 10th to 90th $457 to $7,586Professionalmedian $145 · 10th to 90th $117 to $229
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 $177.83 Median $186.21 Typical High $213.80 | Professional | None | $177.83 | $186.21 | $213.80 |
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 $123.03 Median $144.54 Typical High $208.93 | Professional | None | $123.03 | $144.54 | $208.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $218.78 Typical High $316.23 | Professional | 50 · Both sides | $186.21 | $218.78 | $316.23 |
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 $208.93 Median $208.93 Typical High $223.87 | Professional | None | $208.93 | $208.93 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $239.88 Typical High $1,479.11 | Facility | None | $128.82 | $239.88 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $331.13 | Professional | None | $117.49 | $123.03 | $331.13 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $501.19 | Facility | None | $75.86 | $151.36 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $288.40 | Professional | None | $138.04 | $190.55 | $288.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $204.17 | Professional | None | $81.28 | $138.04 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
MVP Health Care Setting Facility Modifier None Typical Low $141.25 Median $3,235.94 Typical High $4,365.16 | Facility | None | $141.25 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | None | $141.25 | $141.25 | $229.09 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $229.09 | Professional | None | $112.20 | $151.36 | $229.09 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $144.54 Typical High $588.84 | Facility | None | $138.04 | $144.54 | $588.84 |
Univera Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $204.17 | Professional | None | $81.28 | $138.04 | $204.17 |
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 $89.13 Median $93.33 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $37.15 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $138.04 Typical High $151.36 | Professional | 54 · Surgery only | $131.83 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $131.83 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $123.03 | $131.83 | $141.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $138.04 | $186.21 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $20.42 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $20.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $15.49 | $20.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $165.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $138.04 | Professional | 53 · Discontinued | $79.43 | $100.00 | $138.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $138.04 | $186.21 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $30.90 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $30.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.49 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.88 | $15.49 | $30.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $165.96 |
Where New York sits
The same service costs 4.6 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· 46th of 51
$148
AK $603FL $132
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.