How much rates vary
Facilitymedian $3,890 · 10th to 90th $955 to $10,000Professionalmedian $891 · 10th to 90th $724 to $1,995
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,148.15 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,778.28 | Professional | None | $741.31 | $870.96 | $1,778.28 |
CDPHP Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $4,466.84 | Professional | None | $851.14 | $1,096.48 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $1,122.02 Typical High $3,630.78 | Facility | None | $660.69 | $1,122.02 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,230.27 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,174.90 | Professional | None | $691.83 | $870.96 | $1,174.90 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $87,096.36 | Facility | None | $870.96 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,071.52 | $2,344.23 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,884.03 | Professional | None | $794.33 | $1,258.93 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $870.96 Typical High $3,162.28 | Facility | None | $812.83 | $870.96 | $3,162.28 |
Univera Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,174.90 | Professional | None | $691.83 | $870.96 | $1,174.90 |
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 $512.86 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $758.58 Typical High $1,071.52 | Professional | 54 · Surgery only | $602.56 | $758.58 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $162.18 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $134.90 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $660.69 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $524.81 | $660.69 | $933.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $616.60 Typical High $912.01 | Professional | 53 · Discontinued | $446.68 | $616.60 | $912.01 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $758.58 Typical High $1,000.00 | Professional | 54 · Surgery only | $602.56 | $758.58 | $1,000.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $229.09 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $194.98 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $660.69 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $524.81 | $660.69 | $891.25 |
Where New York sits
The same service costs 10.1 times more in Maine than in Arkansas. 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
ME $16,050AR $1,584
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.