How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,000 to $7,762Professionalmedian $389 · 10th to 90th $324 to $891
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 $4,897.79 Typical High $9,120.11 | Facility | None | $1,513.56 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,380.38 | Professional | None | $489.78 | $489.78 | $1,380.38 |
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 $331.13 Median $389.05 Typical High $812.83 | Professional | None | $331.13 | $389.05 | $812.83 |
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 $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,148.15 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $1,659.59 | Professional | None | $331.13 | $549.54 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $1,659.59 | Facility | None | $426.58 | $524.81 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $812.83 | Professional | None | $457.09 | $501.19 | $812.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $524.81 | Professional | None | $281.84 | $380.19 | $524.81 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $457.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,096.48 | Professional | None | $346.74 | $346.74 | $1,096.48 |
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 $323.59 Median $457.09 Typical High $1,202.26 | Professional | None | $323.59 | $457.09 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $1,318.26 | Facility | None | $309.03 | $389.05 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $512.86 | Professional | None | $281.84 | $380.19 | $512.86 |
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 $257.04 | Professional | 52 · Reduced service | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $363.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $489.78 | Professional | 54 · Surgery only | $245.47 | $323.59 | $489.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $79.43 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $79.43 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.02 Typical High $56.23 | Professional | 56 · Pre-op care only | $28.18 | $38.02 | $56.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $288.40 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $213.80 | $288.40 | $426.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $295.12 Typical High $426.58 | Professional | 53 · Discontinued | $218.78 | $295.12 | $426.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $323.59 | $436.52 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $114.82 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $114.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.02 Typical High $83.18 | Professional | 56 · Pre-op care only | $28.18 | $38.02 | $83.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $213.80 | $288.40 | $389.05 |
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 $5,653MT $1,368
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.