How much rates vary
Facilitymedian $3,311 · 10th to 90th $603 to $8,128Professionalmedian $224 · 10th to 90th $123 to $501
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 $524.81 Median $5,888.44 Typical High $12,022.64 | Facility | None | $524.81 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $467.74 | Professional | None | $117.49 | $181.97 | $467.74 |
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 $199.53 Median $239.88 Typical High $407.38 | Professional | None | $199.53 | $239.88 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $354.81 Typical High $616.60 | Professional | 50 · Both sides | $295.12 | $354.81 | $616.60 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $316.23 | Professional | None | $173.78 | $173.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $2,187.76 | Facility | None | $199.53 | $389.05 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $794.33 | Professional | None | $95.50 | $177.83 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $125.89 Median $446.68 Typical High $1,819.70 | Facility | None | $125.89 | $446.68 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $457.09 | Professional | None | $263.03 | $309.03 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $562.34 | Professional | None | $151.36 | $223.87 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $870.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $524.81 | Professional | None | $229.09 | $229.09 | $524.81 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $75.86 Median $181.97 Typical High $549.54 | Professional | None | $75.86 | $181.97 | $549.54 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $239.88 Typical High $3,801.89 | Facility | None | $97.72 | $239.88 | $3,801.89 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $562.34 | Professional | None | $151.36 | $223.87 | $562.34 |
14 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 $58.88 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $58.88 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $54.95 | Professional | 53 · Discontinued | $23.44 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $208.93 | Professional | 54 · Surgery only | $87.10 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $27.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $616.60 Typical High $1,122.02 | Professional | 54 · Surgery only | $398.11 | $616.60 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $70.79 | $109.65 | $141.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $34.67 | $54.95 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $1,122.02 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $141.25 Typical High $229.09 | Professional | 53 · Discontinued | $107.15 | $141.25 | $229.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $616.60 Typical High $1,122.02 | Professional | 54 · Surgery only | $398.11 | $616.60 | $1,122.02 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $109.65 Typical High $426.58 | Professional | 55 · Aftercare only | $70.79 | $109.65 | $426.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $54.95 Typical High $426.58 | Professional | 56 · Pre-op care only | $34.67 | $54.95 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $1,122.02 |
Where New York sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 41st of 51
$240
OK $692TX $214
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.