How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,288 to $11,482Professionalmedian $741 · 10th to 90th $603 to $1,660
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 $831.76 Median $831.76 Typical High $1,949.84 | Professional | None | $831.76 | $831.76 | $1,949.84 |
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 $616.60 Median $724.44 Typical High $1,513.56 | Professional | None | $616.60 | $724.44 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $2,238.72 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $954.99 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $208.93 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $208.93 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,348.96 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $2,951.21 | Professional | None | $630.96 | $870.96 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $3,090.30 | Facility | None | $776.25 | $933.25 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,513.56 | Professional | None | $851.14 | $954.99 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,047.13 | Professional | None | $549.54 | $724.44 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $794.33 Median $4,786.30 Typical High $5,754.40 | Facility | None | $794.33 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,995.26 | Professional | None | $954.99 | $954.99 | $1,995.26 |
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 $602.56 Median $831.76 Typical High $2,238.72 | Professional | None | $602.56 | $831.76 | $2,238.72 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $2,754.23 | Facility | None | $602.56 | $758.58 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,023.29 | Professional | None | $549.54 | $724.44 | $1,023.29 |
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 $416.87 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $707.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $954.99 | Professional | 54 · Surgery only | $478.63 | $616.60 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $154.88 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $72.44 Typical High $112.20 | Professional | 56 · Pre-op care only | $54.95 | $72.44 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $549.54 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $426.58 | $549.54 | $851.14 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $537.03 Typical High $831.76 | Professional | 53 · Discontinued | $407.38 | $537.03 | $831.76 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $478.63 | $616.60 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $223.87 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $72.44 Typical High $162.18 | Professional | 56 · Pre-op care only | $54.95 | $72.44 | $162.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $549.54 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $426.58 | $549.54 | $794.33 |
Where New York sits
The same service costs 7.4 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.
New York· 48th of 51
$759
OK $3,890TX $525
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.