How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,288 to $36,308Professionalmedian $347 · 10th to 90th $269 to $676
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 $1,819.70 Median $5,888.44 Typical High $13,182.57 | Facility | None | $1,819.70 | $5,888.44 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,318.26 | Professional | None | $389.05 | $389.05 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,912.51 Typical High $56,234.13 | Facility | None | $1,737.80 | $8,912.51 | $56,234.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $616.60 | Professional | None | $275.42 | $331.13 | $616.60 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $16,595.87 | Facility | None | $2,290.87 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $10,715.19 Typical High $25,118.86 | Facility | None | $1,445.44 | $10,715.19 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $1,148.15 | Professional | None | $338.84 | $346.74 | $1,148.15 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $1,258.93 | Facility | None | $363.08 | $501.19 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $676.08 | Professional | None | $331.13 | $380.19 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $549.54 | Professional | None | $173.78 | $288.40 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $281.84 Median $4,365.16 Typical High $89,125.09 | Facility | None | $281.84 | $4,365.16 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $870.96 | Professional | None | $363.08 | $363.08 | $870.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $5,128.61 Typical High $25,118.86 | Facility | None | $1,380.38 | $5,128.61 | $25,118.86 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $1,000.00 | Professional | None | $257.04 | $389.05 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $316.23 Typical High $1,000.00 | Facility | None | $223.87 | $316.23 | $1,000.00 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $562.34 | Professional | None | $173.78 | $288.40 | $562.34 |
18 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 $194.98 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $316.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $512.86 | Professional | 54 · Surgery only | $208.93 | $263.03 | $512.86 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.95 Typical High $38.90 | Professional | 55 · Aftercare only | $15.49 | $19.95 | $38.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.70 Typical High $50.12 | Professional | 56 · Pre-op care only | $19.95 | $25.70 | $50.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $467.74 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $446.68 Typical High $512.86 | Facility | 54 · Surgery only | $208.93 | $446.68 | $512.86 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $37.15 Typical High $40.74 | Facility | 55 · Aftercare only | $15.85 | $37.15 | $40.74 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $47.86 Typical High $52.48 | Facility | 56 · Pre-op care only | $19.95 | $47.86 | $52.48 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $446.68 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $186.21 | $446.68 | $489.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $275.42 Typical High $512.86 | Professional | 54 · Surgery only | $208.93 | $275.42 | $512.86 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.38 Typical High $45.71 | Professional | 55 · Aftercare only | $15.49 | $21.38 | $45.71 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $58.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $257.04 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $186.21 | $257.04 | $467.74 |
Where New York sits
The same service costs 21.5 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 $21,837MT $1,015
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.