How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,175 to $9,333Professionalmedian $832 · 10th to 90th $603 to $1,479
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 $1,819.70 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | None | $758.58 | $758.58 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,548.82 | Professional | None | $691.83 | $831.76 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $2,187.76 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $2,187.76 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,380.38 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,584.89 | Professional | None | $562.34 | $1,071.52 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $3,090.30 | Facility | None | $630.96 | $977.24 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,621.81 | Professional | None | $870.96 | $954.99 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,023.29 | Professional | None | $588.84 | $758.58 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $5,754.40 | Facility | None | $851.14 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,548.82 | Professional | None | $977.24 | $977.24 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,479.11 | Professional | None | $501.19 | $812.83 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $2,884.03 | Facility | None | $645.65 | $794.33 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,023.29 | Professional | None | $588.84 | $758.58 | $1,023.29 |
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 $371.54 Median $371.54 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $616.60 | $831.76 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $144.54 Typical High $194.98 | Professional | 55 · Aftercare only | $112.20 | $144.54 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $75.86 Typical High $102.33 | Professional | 56 · Pre-op care only | $58.88 | $75.86 | $102.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $724.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $575.44 Typical High $676.08 | Professional | 53 · Discontinued | $457.09 | $575.44 | $676.08 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $616.60 | $831.76 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $144.54 Typical High $213.80 | Professional | 55 · Aftercare only | $112.20 | $144.54 | $213.80 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $75.86 Typical High $112.20 | Professional | 56 · Pre-op care only | $58.88 | $75.86 | $112.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $794.33 |
Where New York sits
The same service costs 3.5 times more in Wisconsin than in Delaware. 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 $7,647DE $2,171
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.