How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,230 to $11,482Professionalmedian $537 · 10th to 90th $437 to $1,288
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 $1,659.59 Median $5,011.87 Typical High $9,120.11 | Facility | None | $1,659.59 | $5,011.87 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,778.28 | Professional | None | $645.65 | $645.65 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $1,174.90 | Professional | None | $436.52 | $512.86 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $81.28 Typical High $186.21 | Professional | 80 · Assistant surgeon | $69.18 | $81.28 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $72.44 Typical High $165.96 | Professional | AS · PA/NP assist | $60.26 | $72.44 | $165.96 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,148.15 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $2,454.71 | Professional | None | $501.19 | $724.44 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $2,290.87 | Facility | None | $371.54 | $691.83 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,202.26 | Professional | None | $645.65 | $724.44 | $1,202.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $831.76 | Professional | None | $436.52 | $562.34 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $3,235.94 Typical High $4,365.16 | Facility | None | $645.65 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,548.82 | Professional | None | $645.65 | $645.65 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,737.80 | Professional | None | $478.63 | $660.69 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $2,089.30 | Facility | None | $478.63 | $602.56 | $2,089.30 |
Univera Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $794.33 | Professional | None | $436.52 | $562.34 | $794.33 |
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 $398.11 | Professional | 52 · Reduced service | $323.59 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $549.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $489.78 Typical High $758.58 | Professional | 54 · Surgery only | $380.19 | $489.78 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $123.03 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $87.10 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $87.10 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $426.58 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $331.13 | $426.58 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $416.87 Typical High $660.69 | Professional | 53 · Discontinued | $316.23 | $416.87 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $489.78 Typical High $707.95 | Professional | 54 · Surgery only | $380.19 | $489.78 | $707.95 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $177.83 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $331.13 | $426.58 | $630.96 |
Where New York sits
The same service costs 8.1 times more in Oklahoma than in Utah. 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
$562
OK $3,548UT $437
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.