How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,023 to $7,762Professionalmedian $427 · 10th to 90th $339 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 $1,819.70 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,348.96 | Professional | None | $398.11 | $537.03 | $1,348.96 |
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 $346.74 Median $407.38 Typical High $851.14 | Professional | None | $346.74 | $407.38 | $851.14 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,884.03 Typical High $5,623.41 | Facility | None | $1,148.15 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $1,659.59 | Professional | None | $436.52 | $549.54 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $1,584.89 | Facility | None | $302.00 | $489.78 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $831.76 | Professional | None | $446.68 | $512.86 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $630.96 | Professional | None | $309.03 | $389.05 | $630.96 |
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 $630.96 Median $676.08 Typical High $1,122.02 | Professional | None | $630.96 | $676.08 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $1,174.90 | Professional | None | $338.84 | $575.44 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $1,412.54 | Facility | None | $331.13 | $416.87 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $588.84 | Professional | None | $309.03 | $389.05 | $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 $199.53 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $199.53 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $79.43 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $39.81 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $371.54 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $575.44 | Professional | 54 · Surgery only | $263.03 | $338.84 | $575.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $93.33 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $93.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $81.28 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $288.40 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $229.09 | $288.40 | $501.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $302.00 Typical High $467.74 | Professional | 53 · Discontinued | $229.09 | $302.00 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $346.74 Typical High $512.86 | Professional | 54 · Surgery only | $263.03 | $346.74 | $512.86 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $125.89 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $107.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $229.09 | $295.12 | $446.68 |
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· 49th of 51
$447
OK $2,754UT $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.