How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $10,233Professionalmedian $468 · 10th to 90th $372 to $794
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $954.99 | Professional | None | $489.78 | $489.78 | $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 $371.54 Median $436.52 Typical High $630.96 | Professional | None | $371.54 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $660.69 Typical High $954.99 | Professional | 50 · Both sides | $562.34 | $660.69 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $275.42 Typical High $398.11 | Professional | 62 · Two surgeons | $234.42 | $275.42 | $398.11 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,348.96 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,096.48 | Professional | None | $467.74 | $467.74 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $1,905.46 | Facility | None | $512.86 | $724.44 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $831.76 | Professional | None | $436.52 | $549.54 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $645.65 | Professional | None | $275.42 | $436.52 | $645.65 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $489.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,202.26 | Professional | None | $501.19 | $660.69 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $1,174.90 | Professional | None | $331.13 | $501.19 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $436.52 Typical High $2,754.23 | Facility | None | $323.59 | $436.52 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $645.65 | Professional | None | $323.59 | $436.52 | $645.65 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $346.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $537.03 | Professional | 54 · Surgery only | $218.78 | $346.74 | $537.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $91.20 Typical High $144.54 | Professional | 55 · Aftercare only | $57.54 | $91.20 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $69.18 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $69.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $467.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | 53 · Discontinued | $251.19 | $251.19 | $371.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $346.74 | $501.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $91.20 Typical High $257.04 | Professional | 55 · Aftercare only | $57.54 | $91.20 | $257.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $123.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $436.52 |
Where New York sits
The same service costs 4.8 times more in Oklahoma than in Montana. 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 $7,494MT $1,553
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.