How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $9,772Professionalmedian $550 · 10th to 90th $437 to $933
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 $1,698.24 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,698.24 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | None | $562.34 | $562.34 | $630.96 |
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 $436.52 Median $512.86 Typical High $741.31 | Professional | None | $436.52 | $512.86 | $741.31 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,258.93 | Professional | None | $549.54 | $549.54 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $2,238.72 | Facility | None | $562.34 | $676.08 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $977.24 | Professional | None | $512.86 | $645.65 | $977.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $741.31 | Professional | None | $323.59 | $512.86 | $741.31 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $3,235.94 Typical High $4,365.16 | Facility | None | $707.95 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $1,412.54 | Professional | None | $575.44 | $602.56 | $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 $380.19 Median $575.44 Typical High $1,380.38 | Professional | None | $380.19 | $575.44 | $1,380.38 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $2,398.83 | Facility | None | $380.19 | $512.86 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $741.31 | Professional | None | $380.19 | $512.86 | $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 $281.84 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $436.52 |
Excellus BCBS 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 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $107.15 Typical High $154.88 | Professional | 55 · Aftercare only | $67.61 | $107.15 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $512.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $436.52 | Professional | 53 · Discontinued | $288.40 | $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 $107.15 Typical High $309.03 | Professional | 55 · Aftercare only | $67.61 | $107.15 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $147.91 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $147.91 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $512.86 |
Where New York sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.