How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $10,233Professionalmedian $851 · 10th to 90th $692 to $1,622
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,000.00 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,318.26 | Professional | None | $707.95 | $831.76 | $1,318.26 |
CDPHP Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,659.59 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $2,137.96 | Professional | None | $812.83 | $831.76 | $2,137.96 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $1,047.13 Typical High $3,715.35 | Facility | None | $309.03 | $1,047.13 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,737.80 | Professional | None | $912.01 | $1,148.15 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $457.09 Median $891.25 Typical High $1,621.81 | Professional | None | $457.09 | $891.25 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,949.84 | Professional | None | $660.69 | $660.69 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $2,398.83 | Professional | None | $660.69 | $1,023.29 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $2,754.23 | Facility | None | $537.03 | $912.01 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,621.81 | Professional | None | $537.03 | $891.25 | $1,621.81 |
16 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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $707.95 Typical High $1,288.25 | Professional | 54 · Surgery only | $363.08 | $707.95 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $186.21 Typical High $346.74 | Professional | 55 · Aftercare only | $97.72 | $186.21 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $89.13 Typical High $162.18 | Professional | 56 · Pre-op care only | $45.71 | $89.13 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $616.60 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $316.23 | $616.60 | $1,122.02 |
Highmark BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $776.25 | Professional | 53 · Discontinued | $501.19 | $501.19 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $707.95 Typical High $1,288.25 | Professional | 54 · Surgery only | $363.08 | $707.95 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $186.21 Typical High $512.86 | Professional | 55 · Aftercare only | $97.72 | $186.21 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $89.13 Typical High $245.47 | Professional | 56 · Pre-op care only | $45.71 | $89.13 | $245.47 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $616.60 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $316.23 | $616.60 | $1,122.02 |
Where New York sits
The same service costs 6.2 times more in Alabama 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.
Physician feeFacility fee
AL $15,814KY $2,534
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.