How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,202 to $10,965Professionalmedian $741 · 10th to 90th $589 to $1,549
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 $1,548.82 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,548.82 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,995.26 | Professional | None | $891.25 | $954.99 | $1,995.26 |
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 $630.96 Median $741.31 Typical High $1,412.54 | Professional | None | $630.96 | $741.31 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $194.98 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $194.98 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $8,912.51 | Facility | None | $1,023.29 | $4,365.16 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $3,090.30 | Professional | None | $676.08 | $891.25 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $346.74 Median $831.76 Typical High $2,754.23 | Facility | None | $346.74 | $831.76 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,445.44 | Professional | None | $831.76 | $933.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,258.93 | Professional | None | $562.34 | $691.83 | $1,258.93 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,949.84 | Professional | None | $741.31 | $741.31 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,162.28 | $10,232.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $2,187.76 | Professional | None | $588.84 | $831.76 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $660.69 Typical High $2,398.83 | Facility | None | $588.84 | $660.69 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,148.15 | Professional | None | $562.34 | $660.69 | $1,148.15 |
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 $446.68 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $1,174.90 | Professional | 54 · Surgery only | $501.19 | $630.96 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $114.82 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $114.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $102.33 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $102.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $1,071.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | 53 · Discontinued | $398.11 | $524.81 | $794.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $1,148.15 | Professional | 54 · Surgery only | $501.19 | $630.96 | $1,148.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $138.04 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $138.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $123.03 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $123.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $1,047.13 |
Where New York sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.