How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,288 to $15,849Professionalmedian $562 · 10th to 90th $457 to $1,259
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 $1,949.84 Median $6,606.93 Typical High $12,882.50 | Facility | None | $1,949.84 | $6,606.93 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,862.09 | Professional | None | $562.34 | $562.34 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,071.52 | Professional | None | $478.63 | $562.34 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $851.14 Typical High $1,584.89 | Professional | 50 · Both sides | $724.44 | $851.14 | $1,584.89 |
CDPHP Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $16,595.87 Typical High $33,884.42 | Facility | None | $1,445.44 | $16,595.87 | $33,884.42 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $2,454.71 | Professional | None | $446.68 | $741.31 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $776.25 Typical High $2,344.23 | Facility | None | $602.56 | $776.25 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,148.15 | Professional | None | $602.56 | $691.83 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $812.83 | Professional | None | $436.52 | $537.03 | $812.83 |
MVP Health Care Setting Facility Modifier None Typical Low $741.31 Median $4,786.30 Typical High $5,754.40 | Facility | None | $741.31 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,479.11 | Professional | None | $537.03 | $537.03 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,698.24 | Professional | None | $346.74 | $645.65 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $537.03 Typical High $794.33 | Facility | None | $501.19 | $537.03 | $794.33 |
Univera Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $758.58 | Professional | None | $436.52 | $537.03 | $758.58 |
17 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 $281.84 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $467.74 Typical High $741.31 | Professional | 54 · Surgery only | $371.54 | $467.74 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $120.23 | Professional | 55 · Aftercare only | $60.26 | $75.86 | $120.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.02 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $38.02 | $60.26 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $426.58 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $346.74 | $426.58 | $676.08 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $588.84 | Facility | 54 · Surgery only | $436.52 | $489.78 | $588.84 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $97.72 | Facility | 55 · Aftercare only | $70.79 | $79.43 | $97.72 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $48.98 | Facility | 56 · Pre-op care only | $35.48 | $39.81 | $48.98 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $398.11 | $457.09 | $549.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $467.74 Typical High $691.83 | Professional | 54 · Surgery only | $371.54 | $467.74 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $177.83 | Professional | 55 · Aftercare only | $60.26 | $75.86 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.02 Typical High $89.13 | Professional | 56 · Pre-op care only | $30.20 | $38.02 | $89.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $645.65 |
Where New York sits
The same service costs 11.7 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
$562
OK $4,786UT $407
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.