How much rates vary
Facilitymedian $3,311 · 10th to 90th $724 to $7,762Professionalmedian $525 · 10th to 90th $389 to $1,000
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 $446.68 Median $524.81 Typical High $1,230.27 | Professional | None | $446.68 | $524.81 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $8,317.64 | Facility | None | $1,288.25 | $3,981.07 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $870.96 | Professional | None | $446.68 | $524.81 | $870.96 |
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 $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,819.70 | Professional | None | $562.34 | $588.84 | $1,819.70 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $1,737.80 | Facility | None | $446.68 | $537.03 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $891.25 | Professional | None | $478.63 | $549.54 | $891.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $630.96 | Professional | None | $331.13 | $398.11 | $630.96 |
MVP Health Care Setting Facility Modifier None Typical Low $467.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $467.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,174.90 | Professional | None | $630.96 | $1,000.00 | $1,174.90 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,165.95 | Facility | None | $575.44 | $1,737.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,202.26 | Professional | None | $363.08 | $549.54 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $398.11 Median $436.52 Typical High $1,548.82 | Facility | None | $398.11 | $436.52 | $1,548.82 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $588.84 | Professional | None | $331.13 | $398.11 | $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 $223.87 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $371.54 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $512.86 | Professional | 54 · Surgery only | $257.04 | $302.00 | $512.86 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $154.88 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $114.82 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $309.03 Typical High $467.74 | Professional | 53 · Discontinued | $229.09 | $309.03 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $257.04 | $302.00 | $457.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $204.17 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $204.17 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $151.36 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $151.36 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $436.52 |
Where New York sits
The same service costs 7.2 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· 36th of 51
$537
OK $2,042UT $282
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.