How much rates vary
Facilitymedian $2,630 · 10th to 90th $309 to $5,129Professionalmedian $170 · 10th to 90th $107 to $372
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 $173.78 Median $3,548.13 Typical High $7,762.47 | Facility | None | $173.78 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $346.74 | Professional | None | $109.65 | $173.78 | $346.74 |
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 $144.54 Median $173.78 Typical High $346.74 | Professional | None | $144.54 | $173.78 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $257.04 Typical High $512.86 | Professional | 50 · Both sides | $218.78 | $257.04 | $512.86 |
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 $169.82 Median $169.82 Typical High $269.15 | Professional | None | $169.82 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $234.42 Typical High $467.74 | Facility | None | $100.00 | $234.42 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $660.69 | Professional | None | $95.50 | $154.88 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $138.04 Typical High $457.09 | Facility | None | $39.81 | $138.04 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $147.91 Typical High $229.09 | Professional | None | $8.13 | $147.91 | $229.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $229.09 | Professional | None | $123.03 | $181.97 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $141.25 Median $977.24 Typical High $1,412.54 | Facility | None | $141.25 | $977.24 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $467.74 | Professional | None | $44.67 | $44.67 | $467.74 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $446.68 | Professional | None | $77.62 | $158.49 | $446.68 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $407.38 | Facility | None | $97.72 | $169.82 | $407.38 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | None | $123.03 | $169.82 | $213.80 |
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 $54.95 Median $87.10 Typical High $112.20 | Professional | 52 · Reduced service | $54.95 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $21.88 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $83.18 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $33.88 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $158.49 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $112.20 | $165.96 | $218.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.20 Typical High $23.99 | Professional | 55 · Aftercare only | $12.30 | $18.20 | $23.99 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $23.99 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $194.98 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $125.89 Typical High $190.55 | Professional | 53 · Discontinued | $93.33 | $125.89 | $190.55 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $112.20 | $165.96 | $208.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.20 Typical High $35.48 | Professional | 55 · Aftercare only | $12.30 | $18.20 | $35.48 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $35.48 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $181.97 |
Where New York sits
The same service costs 4.1 times more in Alaska 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· 45th of 51
$174
AK $513KY $126
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.