How much rates vary
Facilitymedian $2,692 · 10th to 90th $309 to $5,012Professionalmedian $91 · 10th to 90th $68 to $138
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 $5,888.44 Typical High $10,964.78 | Facility | None | $645.65 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $141.25 | Professional | None | $93.33 | $117.49 | $141.25 |
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 $79.43 Median $93.33 Typical High $131.83 | Professional | None | $79.43 | $93.33 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $199.53 | Professional | 50 · Both sides | $117.49 | $138.04 | $199.53 |
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 $109.65 Median $109.65 Typical High $134.90 | Professional | None | $109.65 | $109.65 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $1,096.48 | Facility | None | $100.00 | $123.03 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $173.78 | Professional | None | $61.66 | $77.62 | $173.78 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $83.18 Typical High $281.84 | Facility | None | $34.67 | $83.18 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $173.78 | Professional | None | $85.11 | $112.20 | $173.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $125.89 | Professional | None | $66.07 | $81.28 | $125.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | None | $89.13 | $117.49 | $117.49 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $154.88 | Professional | None | $67.61 | $67.61 | $154.88 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $4,365.16 | Facility | None | $363.08 | $1,258.93 | $4,365.16 |
United Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $141.25 | Professional | None | $63.10 | $85.11 | $141.25 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $281.84 | Facility | None | $75.86 | $85.11 | $281.84 |
Univera Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $125.89 | Professional | None | $66.07 | $85.11 | $125.89 |
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 $46.77 Median $57.54 Typical High $60.26 | Professional | 52 · Reduced service | $46.77 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $18.62 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $87.10 Typical High $89.13 | Professional | 54 · Surgery only | $70.79 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.33 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $81.28 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $66.07 | $81.28 | $83.18 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $81.28 Typical High $112.20 | Professional | 54 · Surgery only | $69.18 | $81.28 | $112.20 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.12 Typical High $12.59 | Professional | 55 · Aftercare only | $7.76 | $9.12 | $12.59 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.12 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.76 | $9.12 | $12.59 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $72.44 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $61.66 | $72.44 | $100.00 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $97.72 | Professional | 53 · Discontinued | $45.71 | $58.88 | $97.72 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $81.28 Typical High $112.20 | Professional | 54 · Surgery only | $69.18 | $81.28 | $112.20 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.12 Typical High $19.95 | Professional | 55 · Aftercare only | $7.76 | $9.12 | $19.95 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.12 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.76 | $9.12 | $19.95 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $72.44 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $61.66 | $72.44 | $100.00 |
Where New York sits
The same service costs 4.2 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· 45th of 51
$93.33
AK $324FL $77.62
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.