How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,445 to $12,023Professionalmedian $1,230 · 10th to 90th $912 to $1,698
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 $6,165.95 Typical High $14,454.40 | Facility | None | $1,659.59 | $6,165.95 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,380.38 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,000.00 | Professional | None | $912.01 | $954.99 | $1,000.00 |
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 $1,047.13 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,862.09 Typical High $2,454.71 | Professional | 50 · Both sides | $1,584.89 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,023.29 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $263.03 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $229.09 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $229.09 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $4,897.79 Typical High $10,232.93 | Facility | None | $1,819.70 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $2,344.23 | Professional | None | $891.25 | $912.01 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $3,981.07 | Facility | None | $1,202.26 | $1,584.89 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,202.26 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,584.89 | Professional | None | $794.33 | $1,023.29 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,318.26 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,659.59 | $1,659.59 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,589.25 | Facility | None | $1,318.26 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,737.80 | Professional | None | $758.58 | $1,071.52 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $4,677.35 | Facility | None | $758.58 | $1,071.52 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,548.82 | Professional | None | $794.33 | $1,071.52 | $1,548.82 |
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 $616.60 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $891.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $588.84 | $891.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $97.72 Typical High $162.18 | Professional | 55 · Aftercare only | $64.57 | $97.72 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $89.13 Typical High $144.54 | Professional | 56 · Pre-op care only | $58.88 | $89.13 | $144.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $794.33 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $524.81 | $794.33 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $794.33 Typical High $1,202.26 | Professional | 53 · Discontinued | $616.60 | $794.33 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $933.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $588.84 | $933.25 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $251.19 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $93.33 Typical High $229.09 | Professional | 56 · Pre-op care only | $58.88 | $93.33 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $831.76 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $524.81 | $831.76 | $1,288.25 |
Where New York sits
The same service costs 3.0 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 $10,899MT $3,640
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.