How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,096 to $10,000Professionalmedian $447 · 10th to 90th $347 to $794
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 $1,122.02 Median $6,025.60 Typical High $12,882.50 | Facility | None | $1,122.02 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,288.25 | Professional | None | $478.63 | $478.63 | $1,288.25 |
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 $371.54 Median $436.52 Typical High $616.60 | Professional | None | $371.54 | $436.52 | $616.60 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,737.80 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $2,187.76 | Professional | None | $467.74 | $467.74 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $1,778.28 | Facility | None | $257.04 | $549.54 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $831.76 | Professional | None | $436.52 | $549.54 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $630.96 | Professional | None | $275.42 | $436.52 | $630.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $7,943.28 | Facility | None | $1,621.81 | $1,862.09 | $7,943.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,258.93 | Professional | None | $645.65 | $660.69 | $1,258.93 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $489.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $1,202.26 | Professional | None | $309.03 | $309.03 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $1,122.02 | Professional | None | $316.23 | $489.78 | $1,122.02 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $436.52 Typical High $1,621.81 | Facility | None | $323.59 | $436.52 | $1,621.81 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $630.96 | Professional | None | $323.59 | $436.52 | $630.96 |
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 $239.88 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $346.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $346.74 | $501.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $91.20 Typical High $134.90 | Professional | 55 · Aftercare only | $57.54 | $91.20 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $63.10 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $63.10 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $436.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $363.08 | Professional | 53 · Discontinued | $245.47 | $251.19 | $363.08 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $346.74 | $501.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $91.20 Typical High $263.03 | Professional | 55 · Aftercare only | $57.54 | $91.20 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $436.52 |
Where New York sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.