How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,233Professionalmedian $537 · 10th to 90th $437 to $912
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | None | $575.44 | $575.44 | $660.69 |
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 $446.68 Median $524.81 Typical High $741.31 | Professional | None | $446.68 | $524.81 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $776.25 Typical High $1,122.02 | Professional | 50 · Both sides | $660.69 | $776.25 | $1,122.02 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,445.44 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,288.25 | Professional | None | $549.54 | $549.54 | $1,288.25 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $2,187.76 | Facility | None | $602.56 | $758.58 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $954.99 | Professional | None | $512.86 | $630.96 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $741.31 | Professional | None | $323.59 | $501.19 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $602.56 Median $3,235.94 Typical High $4,365.16 | Facility | None | $602.56 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,412.54 | Professional | None | $588.84 | $758.58 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,348.96 | Professional | None | $371.54 | $575.44 | $1,348.96 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $2,454.71 | Facility | None | $380.19 | $512.86 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $741.31 | Professional | None | $380.19 | $501.19 | $741.31 |
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 $288.40 Median $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $398.11 Typical High $630.96 | Professional | 54 · Surgery only | $257.04 | $398.11 | $630.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $104.71 Typical High $165.96 | Professional | 55 · Aftercare only | $67.61 | $104.71 | $165.96 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $79.43 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $79.43 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $346.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $223.87 | $346.74 | $549.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $295.12 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $398.11 Typical High $588.84 | Professional | 54 · Surgery only | $257.04 | $398.11 | $588.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $104.71 Typical High $302.00 | Professional | 55 · Aftercare only | $67.61 | $104.71 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $144.54 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $144.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $346.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $223.87 | $346.74 | $512.86 |
Where New York sits
The same service costs 4.2 times more in Wisconsin than in Montana. 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 $7,546MT $1,803
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.