How much rates vary
Facilitymedian $3,236 · 10th to 90th $851 to $7,413Professionalmedian $309 · 10th to 90th $186 to $513
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 $616.60 Median $4,168.69 Typical High $8,128.31 | Facility | None | $616.60 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $346.74 Typical High $398.11 | Professional | None | $186.21 | $346.74 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $275.42 Median $323.59 Typical High $426.58 | Professional | None | $275.42 | $323.59 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $478.63 Typical High $630.96 | Professional | 50 · Both sides | $407.38 | $478.63 | $630.96 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $489.78 | Professional | None | $263.03 | $263.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $3,019.95 | Facility | None | $954.99 | $1,513.56 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $776.25 | Professional | None | $165.96 | $309.03 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $707.95 | Facility | None | $199.53 | $302.00 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $616.60 | Professional | None | $302.00 | $398.11 | $616.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $426.58 | Professional | None | $181.97 | $323.59 | $426.58 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $3,235.94 Typical High $4,365.16 | Facility | None | $213.80 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $851.14 | Professional | None | $229.09 | $229.09 | $851.14 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,630.27 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,630.27 | $7,244.36 |
United Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $549.54 | Professional | None | $151.36 | $275.42 | $549.54 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $302.00 Typical High $1,047.13 | Facility | None | $123.03 | $302.00 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $426.58 | Professional | None | $213.80 | $316.23 | $426.58 |
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 $93.33 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $239.88 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $288.40 Typical High $380.19 | Professional | 54 · Surgery only | $165.96 | $288.40 | $380.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $18.20 | $31.62 | $42.66 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $42.66 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $257.04 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $147.91 | $257.04 | $338.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $257.04 | Professional | 53 · Discontinued | $177.83 | $181.97 | $257.04 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $288.40 Typical High $380.19 | Professional | 54 · Surgery only | $165.96 | $288.40 | $380.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $79.43 | Professional | 55 · Aftercare only | $18.20 | $31.62 | $79.43 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $79.43 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $79.43 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $257.04 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $147.91 | $257.04 | $338.84 |
Where New York sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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 $5,125ND $804
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.