How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,175 to $11,220Professionalmedian $490 · 10th to 90th $380 to $955
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 $1,412.54 Median $5,888.44 Typical High $11,481.54 | Facility | None | $1,412.54 | $5,888.44 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,819.70 | Professional | None | $549.54 | $549.54 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,513.56 | $4,570.88 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $870.96 | Professional | None | $398.11 | $478.63 | $870.96 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $7,079.46 | Facility | None | $1,445.44 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $1,698.24 | Professional | None | $489.78 | $501.19 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,995.26 | Facility | None | $512.86 | $977.24 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $954.99 | Professional | None | $467.74 | $549.54 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $776.25 | Professional | None | $316.23 | $407.38 | $776.25 |
MVP Health Care Setting Facility Modifier None Typical Low $549.54 Median $4,365.16 Typical High $89,125.09 | Facility | None | $549.54 | $4,365.16 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,258.93 | Professional | None | $707.95 | $707.95 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $14,125.38 | Facility | None | $1,230.27 | $3,162.28 | $14,125.38 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,445.44 | Professional | None | $363.08 | $549.54 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $2,137.96 | Facility | None | $316.23 | $446.68 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $794.33 | Professional | None | $316.23 | $407.38 | $794.33 |
14 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 $275.42 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $380.19 Typical High $741.31 | Professional | 54 · Surgery only | $295.12 | $380.19 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.18 Typical High $54.95 | Professional | 55 · Aftercare only | $22.39 | $28.18 | $54.95 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $36.31 Typical High $70.79 | Professional | 56 · Pre-op care only | $28.84 | $36.31 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $338.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $338.84 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $380.19 Typical High $741.31 | Professional | 54 · Surgery only | $295.12 | $380.19 | $741.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $30.20 Typical High $64.57 | Professional | 55 · Aftercare only | $22.39 | $30.20 | $64.57 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.90 Typical High $83.18 | Professional | 56 · Pre-op care only | $28.84 | $38.90 | $83.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $363.08 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $363.08 | $660.69 |
Where New York sits
The same service costs 5.4 times more in Connecticut 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
CT $7,713MT $1,433
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.