How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,445 to $37,154Professionalmedian $1,072 · 10th to 90th $871 to $2,138
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 $1,905.46 Median $6,918.31 Typical High $24,547.09 | Facility | None | $1,905.46 | $6,918.31 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $5,248.07 | Professional | None | $1,023.29 | $1,023.29 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,912.51 Typical High $41,686.94 | Facility | None | $1,737.80 | $8,912.51 | $41,686.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,949.84 | Professional | None | $870.96 | $1,047.13 | $1,949.84 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $13,489.63 Median $25,703.96 Typical High $51,286.14 | Facility | None | $13,489.63 | $25,703.96 | $51,286.14 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $3,630.78 | Professional | None | $1,148.15 | $1,230.27 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $3,801.89 | Facility | None | $1,096.48 | $1,819.70 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,230.27 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,548.82 | Professional | None | $776.25 | $954.99 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $16,982.44 | Facility | None | $1,202.26 | $1,202.26 | $16,982.44 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,258.93 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,365.16 Typical High $28,183.83 | Facility | None | $1,318.26 | $4,365.16 | $28,183.83 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $2,884.03 | Professional | None | $812.83 | $1,288.25 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $4,073.80 | Facility | None | $1,000.00 | $1,047.13 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,548.82 | Professional | None | $776.25 | $1,000.00 | $1,548.82 |
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 $501.19 Median $501.19 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $1,479.11 | Professional | 54 · Surgery only | $724.44 | $851.14 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $112.20 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $141.25 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $1,318.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $724.44 | $870.96 | $1,445.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $144.54 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $144.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $776.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $645.65 | $776.25 | $1,288.25 |
Where New York sits
The same service costs 8.9 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· 49th of 51
$1,122
OK $7,762TX $871
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.