How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,000 to $7,943Professionalmedian $363 · 10th to 90th $302 to $813
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,047.13 | Professional | None | $478.63 | $478.63 | $1,047.13 |
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 $302.00 Median $354.81 Typical High $724.44 | Professional | None | $302.00 | $354.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $537.03 Typical High $1,096.48 | Professional | 50 · Both sides | $446.68 | $537.03 | $1,096.48 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,318.26 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $1,621.81 | Professional | None | $354.81 | $467.74 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $630.96 Typical High $1,548.82 | Facility | None | $446.68 | $630.96 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $758.58 | Professional | None | $407.38 | $467.74 | $758.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $588.84 | Professional | None | $281.84 | $363.08 | $588.84 |
MVP Health Care Setting Facility Modifier None Typical Low $446.68 Median $3,235.94 Typical High $4,365.16 | Facility | None | $446.68 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,000.00 | Professional | None | $562.34 | $562.34 | $1,000.00 |
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 $288.40 Median $426.58 Typical High $1,096.48 | Professional | None | $288.40 | $426.58 | $1,096.48 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $1,412.54 | Facility | None | $234.42 | $363.08 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $588.84 | Professional | None | $281.84 | $363.08 | $588.84 |
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 $239.88 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 53 · Discontinued | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $331.13 Typical High $602.56 | Professional | 54 · Surgery only | $251.19 | $331.13 | $602.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $66.07 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $66.07 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $66.07 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $66.07 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $537.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $275.42 Typical High $416.87 | Professional | 53 · Discontinued | $208.93 | $275.42 | $416.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $331.13 Typical High $537.03 | Professional | 54 · Surgery only | $251.19 | $331.13 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $81.28 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $81.28 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $81.28 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $81.28 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $478.63 |
Where New York sits
The same service costs 6.0 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
$380
OK $1,862UT $309
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.