How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,715Professionalmedian $646 · 10th to 90th $525 to $1,096
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $758.58 | Professional | None | $676.08 | $691.83 | $758.58 |
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 $537.03 Median $630.96 Typical High $912.01 | Professional | None | $537.03 | $630.96 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $954.99 Typical High $1,348.96 | Professional | 50 · Both sides | $812.83 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $398.11 Typical High $562.34 | Professional | 62 · Two surgeons | $338.84 | $398.11 | $562.34 |
CDPHP Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,445.44 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,479.11 | Professional | None | $660.69 | $660.69 | $1,479.11 |
Emblem Health Setting Facility Modifier None Typical Low $724.44 Median $1,071.52 Typical High $2,511.89 | Facility | None | $724.44 | $1,071.52 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,096.48 | Professional | None | $602.56 | $724.44 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $831.76 | Professional | None | $363.08 | $562.34 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $691.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,698.24 | Professional | None | $691.83 | $977.24 | $1,698.24 |
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 $436.52 Median $676.08 Typical High $1,584.89 | Professional | None | $436.52 | $676.08 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,884.03 | Facility | None | $426.58 | $602.56 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | None | $426.58 | $562.34 | $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 $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $489.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $446.68 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $177.83 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $83.18 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $83.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $575.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $346.74 Typical High $524.81 | Professional | 53 · Discontinued | $338.84 | $346.74 | $524.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $446.68 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $346.74 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $165.96 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $602.56 |
Where New York sits
The same service costs 7.6 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.