How much rates vary
Facilitymedian $3,311 · 10th to 90th $871 to $7,586Professionalmedian $204 · 10th to 90th $162 to $468
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $389.05 | Professional | None | $213.80 | $263.03 | $389.05 |
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 $162.18 Median $190.55 Typical High $416.87 | Professional | None | $162.18 | $190.55 | $416.87 |
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 $263.03 Median $263.03 Typical High $323.59 | Professional | None | $263.03 | $263.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,467.37 | Facility | None | $1,096.48 | $1,737.80 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $831.76 | Professional | None | $165.96 | $239.88 | $831.76 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $724.44 | Facility | None | $199.53 | $346.74 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $467.74 | Professional | None | $251.19 | $288.40 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $363.08 | Professional | None | $162.18 | $218.78 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $199.53 Median $3,235.94 Typical High $4,365.16 | Facility | None | $199.53 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $562.34 | Professional | None | $208.93 | $208.93 | $562.34 |
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 $151.36 Median $223.87 Typical High $602.56 | Professional | None | $151.36 | $223.87 | $602.56 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $645.65 | Facility | None | $158.49 | $208.93 | $645.65 |
Univera Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $363.08 | Professional | None | $162.18 | $208.93 | $363.08 |
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 $107.15 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $52.48 | Professional | 53 · Discontinued | $43.65 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 54 · Surgery only | $162.18 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.38 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $173.78 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $151.36 | $173.78 | $186.21 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $338.84 | Professional | 54 · Surgery only | $144.54 | $199.53 | $338.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $37.15 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $37.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $37.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $177.83 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $128.82 | $177.83 | $302.00 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $151.36 Typical High $234.42 | Professional | 53 · Discontinued | $114.82 | $151.36 | $234.42 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $331.13 | Professional | 54 · Surgery only | $144.54 | $199.53 | $331.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $44.67 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $44.67 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $44.67 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $177.83 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $128.82 | $177.83 | $295.12 |
Where New York sits
The same service costs 5.6 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· 50th of 51
$209
OK $1,148UT $204
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.