How much rates vary
Facilitymedian $3,162 · 10th to 90th $759 to $7,413Professionalmedian $200 · 10th to 90th $148 to $398
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $537.03 | Professional | None | $204.17 | $204.17 | $537.03 |
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 $173.78 Median $204.17 Typical High $354.81 | Professional | None | $173.78 | $204.17 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $302.00 Typical High $524.81 | Professional | 50 · Both sides | $257.04 | $302.00 | $524.81 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,290.87 | Facility | None | $794.33 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $758.58 | Professional | None | $147.91 | $239.88 | $758.58 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $190.55 Typical High $660.69 | Facility | None | $39.81 | $190.55 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $338.84 | Professional | None | $177.83 | $204.17 | $338.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $239.88 | Professional | None | $125.89 | $169.82 | $239.88 |
MVP Health Care Setting Facility Modifier None Typical Low $208.93 Median $3,235.94 Typical High $4,365.16 | Facility | None | $208.93 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $467.74 | Professional | None | $79.43 | $79.43 | $467.74 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $512.86 | Professional | None | $138.04 | $194.98 | $512.86 |
Univera Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $549.54 | Facility | None | $134.90 | $177.83 | $549.54 |
Univera Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $229.09 | Professional | None | $125.89 | $169.82 | $229.09 |
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 $102.33 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $165.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $229.09 | Professional | 54 · Surgery only | $112.20 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $25.12 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $25.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $25.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $128.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $100.00 | $128.82 | $204.17 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $125.89 Typical High $190.55 | Professional | 53 · Discontinued | $95.50 | $125.89 | $190.55 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $144.54 | $213.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $36.31 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $36.31 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $36.31 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $128.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $100.00 | $128.82 | $190.55 |
Where New York sits
The same service costs 8.9 times more in Oklahoma than in Utah. 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.
New York· 46th of 51
$204
OK $1,413UT $158
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.