How much rates vary
Facilitymedian $3,467 · 10th to 90th $575 to $10,471Professionalmedian $380 · 10th to 90th $275 to $794
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 $288.40 Median $3,162.28 Typical High $8,128.31 | Facility | None | $288.40 | $3,162.28 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $691.83 | Professional | None | $245.47 | $389.05 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $4,265.80 Typical High $18,620.87 | Facility | None | $1,288.25 | $4,265.80 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $794.33 | Professional | None | $309.03 | $363.08 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $229.09 Typical High $501.19 | Professional | 62 · Two surgeons | $194.98 | $229.09 | $501.19 |
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 $316.23 Median $316.23 Typical High $602.56 | Professional | None | $316.23 | $316.23 | $602.56 |
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 $229.09 Median $457.09 Typical High $1,318.26 | Professional | None | $229.09 | $457.09 | $1,318.26 |
Emblem Health Setting Facility Modifier None Typical Low $229.09 Median $524.81 Typical High $933.25 | Facility | None | $229.09 | $524.81 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $831.76 | Professional | None | $436.52 | $512.86 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $575.44 | Professional | None | $275.42 | $380.19 | $575.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $9,120.11 | Facility | None | $2,238.72 | $3,548.13 | $9,120.11 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $1,819.70 | Facility | None | $309.03 | $309.03 | $1,819.70 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,000.00 | Professional | None | $389.05 | $389.05 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $9,549.93 | Facility | None | $1,122.02 | $2,754.23 | $9,549.93 |
United Setting Professional Modifier None Typical Low $199.53 Median $407.38 Typical High $912.01 | Professional | None | $199.53 | $407.38 | $912.01 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $407.38 Typical High $977.24 | Facility | None | $162.18 | $407.38 | $977.24 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $524.81 | Professional | None | $275.42 | $380.19 | $524.81 |
6 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 $144.54 Median $190.55 Typical High $257.04 | Professional | 52 · Reduced service | $144.54 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $77.62 Typical High $104.71 | Professional | 53 · Discontinued | $57.54 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $288.40 Typical High $389.05 | Professional | 54 · Surgery only | $218.78 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $57.54 Typical High $77.62 | Professional | 55 · Aftercare only | $43.65 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.90 Typical High $51.29 | Professional | 56 · Pre-op care only | $28.84 | $38.90 | $51.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $263.03 Typical High $426.58 | Professional | 53 · Discontinued | $199.53 | $263.03 | $426.58 |
Where New York sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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 $4,893WV $835
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.