How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,122 to $9,333Professionalmedian $575 · 10th to 90th $468 to $1,000
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 $1,380.38 Median $4,786.30 Typical High $8,317.64 | Facility | None | $1,380.38 | $4,786.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,174.90 | Professional | None | $630.96 | $630.96 | $1,174.90 |
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 $478.63 Median $562.34 Typical High $812.83 | Professional | None | $478.63 | $562.34 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,202.26 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,202.26 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,148.15 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,380.38 | Professional | None | $575.44 | $575.44 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $676.08 Typical High $2,238.72 | Facility | None | $251.19 | $676.08 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,023.29 | Professional | None | $549.54 | $676.08 | $1,023.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $794.33 | Professional | None | $338.84 | $537.03 | $794.33 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $630.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,513.56 | Professional | None | $630.96 | $812.83 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,445.44 | Professional | None | $407.38 | $616.60 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $2,884.03 | Facility | None | $398.11 | $549.54 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $794.33 | Professional | None | $398.11 | $537.03 | $794.33 |
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 $309.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $426.58 Typical High $616.60 | Professional | 54 · Surgery only | $269.15 | $426.58 | $616.60 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $112.20 Typical High $165.96 | Professional | 55 · Aftercare only | $72.44 | $112.20 | $165.96 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $79.43 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $79.43 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $549.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $467.74 | Professional | 53 · Discontinued | $316.23 | $323.59 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $426.58 Typical High $616.60 | Professional | 54 · Surgery only | $269.15 | $426.58 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $112.20 Typical High $331.13 | Professional | 55 · Aftercare only | $72.44 | $112.20 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $154.88 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $154.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $549.54 |
Where New York sits
The same service costs 3.6 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 $6,890MT $1,932
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.