How much rates vary
Facilitymedian $3,311 · 10th to 90th $871 to $7,586Professionalmedian $1,549 · 10th to 90th $275 to $3,890
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 $5,370.32 Typical High $11,481.54 | Facility | None | $1,819.70 | $5,370.32 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,884.03 | Professional | None | $251.19 | $1,202.26 | $2,884.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $851.14 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $177.83 | $851.14 | $1,995.26 |
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 $1,258.93 Median $1,479.11 Typical High $3,890.45 | Professional | None | $1,258.93 | $1,479.11 | $3,890.45 |
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 $316.23 Median $316.23 Typical High $3,388.44 | Professional | None | $316.23 | $316.23 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $3,548.13 | Facility | None | $1,230.27 | $2,187.76 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $1,737.80 Typical High $5,623.41 | Professional | None | $190.55 | $1,737.80 | $5,623.41 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $831.76 | Facility | None | $218.78 | $275.42 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,630.27 | $2,951.21 | $4,897.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $2,187.76 Typical High $3,311.31 | Professional | None | $912.01 | $2,187.76 | $3,311.31 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,905.46 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,905.46 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $3,235.94 Typical High $4,365.16 | Facility | None | $389.05 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $4,677.35 | Professional | None | $2,187.76 | $2,187.76 | $4,677.35 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $181.97 Median $1,412.54 Typical High $4,073.80 | Professional | None | $181.97 | $1,412.54 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $186.21 Median $630.96 Typical High $2,630.27 | Facility | None | $186.21 | $630.96 | $2,630.27 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $2,187.76 | Facility | 78 · Unplanned return to OR | $154.88 | $218.78 | $2,187.76 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $2,187.76 Typical High $3,311.31 | Professional | None | $912.01 | $2,187.76 | $3,311.31 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,905.46 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,905.46 | $2,951.21 |
10 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 54 · Surgery only Typical Low $190.55 Median $912.01 Typical High $2,137.96 | Professional | 54 · Surgery only | $190.55 | $912.01 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,089.30 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,445.44 | $2,089.30 | $3,235.94 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $204.17 Typical High $316.23 | Professional | 55 · Aftercare only | $141.25 | $204.17 | $316.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $281.84 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $281.84 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $2,398.83 | Facility | 54 · Surgery only | $169.82 | $239.88 | $2,398.83 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $234.42 | Facility | 55 · Aftercare only | $16.60 | $23.44 | $234.42 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.89 Typical High $208.93 | Facility | 56 · Pre-op care only | $14.79 | $20.89 | $208.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,089.30 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,445.44 | $2,089.30 | $3,162.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $204.17 Typical High $398.11 | Professional | 55 · Aftercare only | $141.25 | $204.17 | $398.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $346.74 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $346.74 |
Where New York sits
The same service costs 7.1 times more in Oregon than in Texas. 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· 30th of 51
$1,549
OR $2,884TX $407
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.