How much rates vary
Facilitymedian $2,570 · 10th to 90th $204 to $5,012Professionalmedian $132 · 10th to 90th $93 to $191
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 $181.97 Median $3,981.07 Typical High $8,128.31 | Facility | None | $181.97 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $199.53 | Professional | None | $128.82 | $151.36 | $199.53 |
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 $114.82 Median $134.90 Typical High $186.21 | Professional | None | $114.82 | $134.90 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $204.17 Typical High $269.15 | Professional | 50 · Both sides | $173.78 | $204.17 | $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 $162.18 Median $162.18 Typical High $186.21 | Professional | None | $162.18 | $162.18 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $346.74 | Facility | None | $100.00 | $169.82 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $257.04 | Professional | None | $93.33 | $107.15 | $257.04 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $120.23 Typical High $407.38 | Facility | None | $34.67 | $120.23 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $245.47 | Professional | None | $117.49 | $158.49 | $245.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $173.78 | Professional | None | $66.07 | $114.82 | $173.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | None | $154.88 | $162.18 | $162.18 |
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 $79.43 Median $79.43 Typical High $190.55 | Professional | None | $79.43 | $79.43 | $190.55 |
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 $93.33 Median $123.03 Typical High $190.55 | Professional | None | $93.33 | $123.03 | $190.55 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $117.49 Typical High $302.00 | Facility | None | $112.20 | $117.49 | $302.00 |
Univera Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $173.78 | Professional | None | $66.07 | $114.82 | $173.78 |
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 $69.18 Median $75.86 Typical High $79.43 | Professional | 52 · Reduced service | $69.18 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.20 Typical High $32.36 | Professional | 53 · Discontinued | $27.54 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $114.82 Typical High $120.23 | Professional | 54 · Surgery only | $104.71 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $22.91 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.80 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $97.72 | $107.15 | $112.20 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $114.82 Typical High $154.88 | Professional | 54 · Surgery only | $97.72 | $114.82 | $154.88 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.88 Typical High $17.38 | Professional | 55 · Aftercare only | $10.72 | $12.88 | $17.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $17.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $138.04 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $117.49 | Professional | 53 · Discontinued | $66.07 | $83.18 | $117.49 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $114.82 Typical High $154.88 | Professional | 54 · Surgery only | $97.72 | $114.82 | $154.88 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.88 Typical High $28.18 | Professional | 55 · Aftercare only | $10.72 | $12.88 | $28.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $28.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $138.04 |
Where New York sits
The same service costs 4.4 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· 39th of 51
$135
AK $468FL $107
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.