How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,349 to $11,482Professionalmedian $871 · 10th to 90th $692 to $1,514
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 $5,754.40 Typical High $10,964.78 | Facility | None | $1,819.70 | $5,754.40 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | None | $891.25 | $891.25 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,174.90 | Professional | None | $741.31 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $549.54 Typical High $724.44 | Professional | 62 · Two surgeons | $467.74 | $549.54 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $134.90 Typical High $218.78 | Professional | 80 · Assistant surgeon | $117.49 | $134.90 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $165.96 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
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 $2,238.72 Median $6,165.95 Typical High $12,589.25 | Facility | None | $2,238.72 | $6,165.95 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,041.74 | Professional | None | $870.96 | $870.96 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,174.90 Typical High $3,548.13 | Facility | None | $954.99 | $1,174.90 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,584.89 | Professional | None | $794.33 | $891.25 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $812.83 Typical High $1,513.56 | Professional | None | $426.58 | $812.83 | $1,513.56 |
Highmark BCBS 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 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $5,754.40 Typical High $38,018.94 | Facility | None | $831.76 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $2,290.87 | Professional | None | $912.01 | $1,023.29 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,791.08 | Facility | None | $1,318.26 | $4,168.69 | $14,791.08 |
United Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $2,137.96 | Professional | None | $602.56 | $933.25 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $2,951.21 | Facility | None | $501.19 | $794.33 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,513.56 | Professional | None | $501.19 | $794.33 | $1,513.56 |
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 $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $645.65 Typical High $1,174.90 | Professional | 54 · Surgery only | $331.13 | $645.65 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $169.82 Typical High $316.23 | Professional | 55 · Aftercare only | $89.13 | $169.82 | $316.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $151.36 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $562.34 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $288.40 | $562.34 | $1,023.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | 53 · Discontinued | $457.09 | $457.09 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $645.65 Typical High $1,174.90 | Professional | 54 · Surgery only | $331.13 | $645.65 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $169.82 Typical High $467.74 | Professional | 55 · Aftercare only | $89.13 | $169.82 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $223.87 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $562.34 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $288.40 | $562.34 | $1,023.29 |
Where New York sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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
OK $11,738KY $2,311
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.