How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,000 to $10,715Professionalmedian $457 · 10th to 90th $372 to $912
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 $1,047.13 Median $5,370.32 Typical High $10,471.29 | Facility | None | $1,047.13 | $5,370.32 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $1,230.27 | Professional | None | $512.86 | $537.03 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $4,265.80 Typical High $15,848.93 | Facility | None | $1,288.25 | $4,265.80 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $812.83 | Professional | None | $389.05 | $457.09 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $691.83 Typical High $1,202.26 | Professional | 50 · Both sides | $588.84 | $691.83 | $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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,348.96 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,778.28 | Professional | None | $389.05 | $537.03 | $1,778.28 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $724.44 Typical High $1,737.80 | Facility | None | $489.78 | $724.44 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $831.76 | Professional | None | $478.63 | $524.81 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $660.69 | Professional | None | $309.03 | $398.11 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $489.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,122.02 | Professional | None | $602.56 | $602.56 | $1,122.02 |
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 $323.59 Median $478.63 Typical High $1,230.27 | Professional | None | $323.59 | $478.63 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $1,584.89 | Facility | None | $263.03 | $407.38 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $660.69 | Professional | None | $309.03 | $398.11 | $660.69 |
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 $269.15 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $363.08 Typical High $660.69 | Professional | 54 · Surgery only | $275.42 | $363.08 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $39.81 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $39.81 | $74.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $39.81 Typical High $74.13 | Professional | 56 · Pre-op care only | $30.90 | $39.81 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $323.59 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $245.47 | $323.59 | $588.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $302.00 Typical High $457.09 | Professional | 53 · Discontinued | $234.42 | $302.00 | $457.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $363.08 Typical High $588.84 | Professional | 54 · Surgery only | $275.42 | $363.08 | $588.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $39.81 Typical High $89.13 | Professional | 55 · Aftercare only | $30.90 | $39.81 | $89.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $39.81 Typical High $89.13 | Professional | 56 · Pre-op care only | $30.90 | $39.81 | $89.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $323.59 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $245.47 | $323.59 | $524.81 |
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· 48th of 51
$490
OK $3,020UT $339
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.