How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,715Professionalmedian $603 · 10th to 90th $479 to $1,047
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 $10,715.19 | Facility | None | $1,819.70 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,258.93 | Professional | None | $645.65 | $645.65 | $1,258.93 |
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 $489.78 Median $575.44 Typical High $831.76 | Professional | None | $489.78 | $575.44 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $870.96 Typical High $1,258.93 | Professional | 50 · Both sides | $741.31 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $363.08 Typical High $524.81 | Professional | 62 · Two surgeons | $309.03 | $363.08 | $524.81 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $602.56 Median $602.56 Typical High $1,412.54 | Professional | None | $602.56 | $602.56 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $2,398.83 | Facility | None | $645.65 | $794.33 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $1,071.52 | Professional | None | $575.44 | $588.84 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $831.76 | Professional | None | $363.08 | $549.54 | $831.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $4,786.30 Typical High $5,754.40 | Facility | None | $616.60 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,584.89 | Professional | None | $645.65 | $812.83 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,513.56 | Professional | None | $407.38 | $630.96 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $3,019.95 | Facility | None | $426.58 | $575.44 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $831.76 | Professional | None | $426.58 | $549.54 | $831.76 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $436.52 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $114.82 Typical High $177.83 | Professional | 55 · Aftercare only | $75.86 | $114.82 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $54.95 Typical High $85.11 | Professional | 56 · Pre-op care only | $36.31 | $54.95 | $85.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $380.19 | $575.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $478.63 | Professional | 53 · Discontinued | $323.59 | $331.13 | $478.63 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $436.52 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $114.82 Typical High $338.84 | Professional | 55 · Aftercare only | $75.86 | $114.82 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $54.95 Typical High $162.18 | Professional | 56 · Pre-op care only | $36.31 | $54.95 | $162.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $380.19 | $575.44 |
Where New York sits
The same service costs 4.4 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 $8,870MT $2,000
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.