How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,023 to $8,128Professionalmedian $380 · 10th to 90th $316 to $851
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $1,122.02 | Professional | None | $489.78 | $524.81 | $1,122.02 |
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 $316.23 Median $371.54 Typical High $758.58 | Professional | None | $316.23 | $371.54 | $758.58 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,884.03 Typical High $5,623.41 | Facility | None | $1,148.15 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $1,659.59 | Professional | None | $371.54 | $489.78 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $1,513.56 | Facility | None | $371.54 | $489.78 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $794.33 | Professional | None | $416.87 | $478.63 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $676.08 | Professional | None | $302.00 | $380.19 | $676.08 |
MVP Health Care Setting Facility Modifier None Typical Low $467.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $467.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,047.13 | Professional | None | $549.54 | $549.54 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,174.90 | Professional | None | $323.59 | $446.68 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $354.81 Median $380.19 Typical High $1,412.54 | Facility | None | $354.81 | $380.19 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $630.96 | Professional | None | $302.00 | $380.19 | $630.96 |
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 $245.47 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $363.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $346.74 | $630.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $63.10 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $56.23 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $56.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $316.23 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $316.23 | $575.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $281.84 Typical High $436.52 | Professional | 53 · Discontinued | $218.78 | $281.84 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $616.60 | Professional | 54 · Surgery only | $275.42 | $346.74 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $75.86 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $75.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $67.61 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $67.61 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $316.23 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $251.19 | $316.23 | $562.34 |
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· 49th of 51
$398
OK $2,951UT $331
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.