How much rates vary
Facilitymedian $4,571 · 10th to 90th $933 to $10,965Professionalmedian $513 · 10th to 90th $389 to $1,259
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 $512.86 Median $4,365.16 Typical High $10,715.19 | Facility | None | $512.86 | $4,365.16 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $1,148.15 | Professional | None | $426.58 | $512.86 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $1,047.13 | Professional | None | $416.87 | $489.78 | $1,047.13 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,148.15 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | None | $676.08 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,445.44 | $3,235.94 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $2,187.76 | Professional | None | $316.23 | $457.09 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $537.03 Typical High $1,862.09 | Facility | None | $275.42 | $537.03 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,348.96 | Professional | None | $724.44 | $831.76 | $1,348.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $776.25 | Professional | None | $416.87 | $588.84 | $776.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $10,715.19 | Facility | None | $1,621.81 | $2,137.96 | $10,715.19 |
MVP Health Care Setting Facility Modifier None Typical Low $588.84 Median $4,365.16 Typical High $23,442.29 | Facility | None | $588.84 | $4,365.16 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Professional | None | $524.81 | $524.81 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $1,479.11 | Professional | None | $331.13 | $549.54 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $537.03 Typical High $707.95 | Facility | None | $380.19 | $537.03 | $707.95 |
Univera Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $707.95 | Professional | None | $416.87 | $549.54 | $707.95 |
13 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 |
|---|---|---|---|---|---|
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $630.96 | Professional | 54 · Surgery only | $323.59 | $501.19 | $630.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $131.83 Typical High $169.82 | Professional | 55 · Aftercare only | $87.10 | $131.83 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $63.10 Typical High $81.28 | Professional | 56 · Pre-op care only | $41.69 | $63.10 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $436.52 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $281.84 | $436.52 | $562.34 |
Highmark BCBS Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 51 · Multiple procedures + 59 · Distinct service | $575.44 | $575.44 | $575.44 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $562.34 | Facility | 54 · Surgery only | $302.00 | $331.13 | $562.34 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $151.36 | Facility | 55 · Aftercare only | $79.43 | $89.13 | $151.36 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $38.02 Median $48.98 Typical High $70.79 | Facility | 56 · Pre-op care only | $38.02 | $48.98 | $70.79 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $263.03 | $288.40 | $489.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $323.59 | $501.19 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $131.83 Typical High $251.19 | Professional | 55 · Aftercare only | $87.10 | $131.83 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $63.10 Typical High $120.23 | Professional | 56 · Pre-op care only | $41.69 | $63.10 | $120.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $281.84 | $436.52 | $537.03 |
Where New York sits
The same service costs 6.0 times more in Wisconsin than in West Virginia. 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.
Physician feeFacility fee
WI $7,172WV $1,205
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.