How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,148 to $9,550Professionalmedian $646 · 10th to 90th $513 to $1,349
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 $1,584.89 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,584.89 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,862.09 | Professional | None | $812.83 | $812.83 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,202.26 | Professional | None | $549.54 | $645.65 | $1,202.26 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,548.82 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $2,630.27 | Professional | None | $588.84 | $724.44 | $2,630.27 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $776.25 Typical High $2,570.40 | Facility | None | $616.60 | $776.25 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,258.93 | Professional | None | $660.69 | $758.58 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $977.24 | Professional | None | $457.09 | $602.56 | $977.24 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $4,786.30 | Facility | None | $812.83 | $812.83 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,659.59 | Professional | None | $602.56 | $602.56 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,754.23 | $7,943.28 |
United Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,819.70 | Professional | None | $478.63 | $707.95 | $1,819.70 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $602.56 Typical High $1,737.80 | Facility | None | $389.05 | $602.56 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $977.24 | Professional | None | $457.09 | $602.56 | $977.24 |
18 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 $407.38 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $616.60 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $537.03 Typical High $1,000.00 | Professional | 54 · Surgery only | $416.87 | $537.03 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $109.65 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $109.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $109.65 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $478.63 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $371.54 | $478.63 | $870.96 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $354.81 Median $724.44 Typical High $954.99 | Facility | 54 · Surgery only | $354.81 | $724.44 | $954.99 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $79.43 Typical High $120.23 | Facility | 55 · Aftercare only | $38.90 | $79.43 | $120.23 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $79.43 Typical High $120.23 | Facility | 56 · Pre-op care only | $38.90 | $79.43 | $120.23 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $645.65 Typical High $954.99 | Facility | 78 · Unplanned return to OR | $316.23 | $645.65 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $537.03 Typical High $891.25 | Professional | 54 · Surgery only | $416.87 | $537.03 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $60.26 Typical High $134.90 | Professional | 55 · Aftercare only | $45.71 | $60.26 | $134.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $60.26 Typical High $134.90 | Professional | 56 · Pre-op care only | $45.71 | $60.26 | $134.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $478.63 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $371.54 | $478.63 | $794.33 |
Where New York sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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
OK $7,369KY $1,773
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.