How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,233Professionalmedian $692 · 10th to 90th $575 to $1,445
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,698.24 | Professional | None | $645.65 | $645.65 | $1,698.24 |
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 $575.44 Median $691.83 Typical High $1,318.26 | Professional | None | $575.44 | $691.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $208.93 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $97.72 Typical High $186.21 | Professional | AS · PA/NP assist | $81.28 | $97.72 | $186.21 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,754.23 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,949.84 | Professional | None | $645.65 | $645.65 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $3,162.28 | Facility | None | $691.83 | $933.25 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,737.80 | Professional | None | $870.96 | $1,000.00 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,071.52 | Professional | None | $363.08 | $691.83 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $575.44 Median $5,754.40 Typical High $36,307.81 | Facility | None | $575.44 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,905.46 | Professional | None | $602.56 | $602.56 | $1,905.46 |
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 $602.56 Median $870.96 Typical High $2,187.76 | Professional | None | $602.56 | $870.96 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $3,715.35 | Facility | None | $524.81 | $691.83 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,071.52 | Professional | None | $363.08 | $691.83 | $1,071.52 |
14 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 $478.63 | Professional | 52 · Reduced service | $323.59 | $323.59 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $489.78 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $660.69 Typical High $1,000.00 | Professional | 54 · Surgery only | $457.09 | $660.69 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $48.98 Typical High $75.86 | Professional | 55 · Aftercare only | $34.67 | $48.98 | $75.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $63.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $44.67 | $63.10 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $912.01 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $660.69 Typical High $977.24 | Professional | 54 · Surgery only | $457.09 | $660.69 | $977.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $48.98 Typical High $100.00 | Professional | 55 · Aftercare only | $34.67 | $48.98 | $100.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $63.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $44.67 | $63.10 | $128.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $891.25 |
Where New York sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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
$741
OK $4,169KY $617
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.