How much rates vary
Facilitymedian $3,236 · 10th to 90th $513 to $7,586Professionalmedian $178 · 10th to 90th $141 to $407
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $436.52 | Professional | None | $190.55 | $218.78 | $436.52 |
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 $144.54 Median $169.82 Typical High $346.74 | Professional | None | $144.54 | $169.82 | $346.74 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | None | $234.42 | $234.42 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $234.42 Typical High $1,778.28 | Facility | None | $123.03 | $234.42 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $707.95 | Professional | None | $147.91 | $199.53 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $177.83 Median $239.88 Typical High $616.60 | Facility | None | $177.83 | $239.88 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $389.05 | Professional | None | $208.93 | $239.88 | $389.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $302.00 | Professional | None | $134.90 | $169.82 | $302.00 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $173.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $467.74 | Professional | None | $141.25 | $141.25 | $467.74 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $524.81 | Professional | None | $134.90 | $190.55 | $524.81 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $524.81 | Facility | None | $138.04 | $169.82 | $524.81 |
Univera Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $275.42 | Professional | None | $134.90 | $169.82 | $275.42 |
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 $95.50 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $95.50 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $44.67 | Professional | 53 · Discontinued | $38.02 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $165.96 | Professional | 54 · Surgery only | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $131.83 | $144.54 | $154.88 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $162.18 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $162.18 | $275.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $30.90 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $30.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.49 | $18.20 | $30.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $245.47 |
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 $120.23 Median $162.18 Typical High $269.15 | Professional | 54 · Surgery only | $120.23 | $162.18 | $269.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $37.15 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $37.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.49 | $18.20 | $37.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $239.88 |
Where New York sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 49th of 51
$182
OK $891FL $182
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.