How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $11,482Professionalmedian $1,585 · 10th to 90th $427 to $2,512
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,778.28 Typical High $1,949.84 | Professional | None | $426.58 | $1,778.28 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $12,302.69 | Facility | None | $1,513.56 | $4,897.79 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,584.89 | $2,137.96 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $16,595.87 | Facility | None | $2,290.87 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $2,691.53 | Professional | None | $575.44 | $575.44 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $5,623.41 | Facility | None | $1,737.80 | $2,818.38 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,513.56 Typical High $3,235.94 | Professional | None | $380.19 | $1,513.56 | $3,235.94 |
Emblem Health Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $1,479.11 | Facility | None | $389.05 | $512.86 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,137.96 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,659.59 Typical High $2,884.03 | Professional | None | $812.83 | $1,659.59 | $2,884.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Facility | None | $10,471.29 | $10,471.29 | $10,471.29 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $4,365.16 Typical High $38,018.94 | Facility | None | $489.78 | $4,365.16 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,737.80 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,235.94 | $9,772.37 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,122.02 Typical High $2,630.27 | Professional | None | $331.13 | $1,122.02 | $2,630.27 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $977.24 Typical High $2,884.03 | Facility | None | $223.87 | $977.24 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,884.03 | Professional | None | $954.99 | $1,659.59 | $2,884.03 |
19 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 $213.80 Median $891.25 Typical High $977.24 | Professional | 52 · Reduced service | $213.80 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $354.81 Typical High $398.11 | Professional | 53 · Discontinued | $85.11 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $1,318.26 Typical High $1,479.11 | Professional | 54 · Surgery only | $323.59 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $64.57 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $177.83 Typical High $194.98 | Professional | 56 · Pre-op care only | $42.66 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $1,230.27 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $302.00 | $1,230.27 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,513.56 Typical High $2,570.40 | Professional | 54 · Surgery only | $724.44 | $1,513.56 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $165.96 Typical High $288.40 | Professional | 55 · Aftercare only | $81.28 | $165.96 | $288.40 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $165.96 Typical High $288.40 | Professional | 56 · Pre-op care only | $81.28 | $165.96 | $288.40 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,348.96 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $645.65 | $1,348.96 | $2,290.87 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $1,348.96 | Professional | 53 · Discontinued | $933.25 | $933.25 | $1,348.96 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $512.86 Typical High $2,570.40 | Facility | 54 · Surgery only | $204.17 | $512.86 | $2,570.40 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $64.57 Typical High $288.40 | Facility | 55 · Aftercare only | $22.39 | $64.57 | $288.40 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $64.57 Typical High $288.40 | Facility | 56 · Pre-op care only | $22.39 | $64.57 | $288.40 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $512.86 Typical High $2,290.87 | Facility | 78 · Unplanned return to OR | $181.97 | $512.86 | $2,290.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,513.56 Typical High $2,570.40 | Professional | 54 · Surgery only | $724.44 | $1,513.56 | $2,570.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $169.82 Typical High $363.08 | Professional | 55 · Aftercare only | $81.28 | $169.82 | $363.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $169.82 Typical High $363.08 | Professional | 56 · Pre-op care only | $81.28 | $169.82 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,348.96 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $645.65 | $1,348.96 | $2,290.87 |
Where New York sits
The same service costs 4.4 times more in Oklahoma than in Maryland. 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
OK $10,373MD $2,367
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.