How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,096 to $8,710Professionalmedian $813 · 10th to 90th $617 to $1,698
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 $1,548.82 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,548.82 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,238.72 | Professional | None | $812.83 | $812.83 | $2,238.72 |
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 $691.83 Median $812.83 Typical High $1,548.82 | Professional | None | $691.83 | $812.83 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $2,344.23 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $2,344.23 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,023.29 | $2,511.89 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $3,162.28 | Professional | None | $645.65 | $870.96 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $2,951.21 | Facility | None | $691.83 | $933.25 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,513.56 | Professional | None | $891.25 | $977.24 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,047.13 | Professional | None | $562.34 | $724.44 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,000.00 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $2,344.23 | Professional | None | $478.63 | $851.14 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $2,691.53 | Facility | None | $616.60 | $645.65 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,047.13 | Professional | None | $562.34 | $707.95 | $1,047.13 |
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 $407.38 Median $407.38 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $954.99 | Professional | 54 · Surgery only | $478.63 | $616.60 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $154.88 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $77.62 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $77.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $870.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $562.34 Typical High $851.14 | Professional | 53 · Discontinued | $426.58 | $562.34 | $851.14 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $478.63 | $616.60 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $229.09 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $114.82 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $114.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $831.76 |
Where New York sits
The same service costs 6.9 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· 48th of 51
$832
OK $3,890UT $562
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.