How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,288 to $10,471Professionalmedian $724 · 10th to 90th $575 to $1,479
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 $1,698.24 Median $5,370.32 Typical High $9,772.37 | Facility | None | $1,698.24 | $5,370.32 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,862.09 | Professional | None | $891.25 | $891.25 | $1,862.09 |
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 $616.60 Median $724.44 Typical High $1,318.26 | Professional | None | $616.60 | $724.44 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $186.21 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $186.21 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,318.26 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $2,951.21 | Professional | None | $645.65 | $812.83 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $1,318.26 Typical High $2,754.23 | Facility | None | $794.33 | $1,318.26 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,348.96 | Professional | None | $724.44 | $831.76 | $1,348.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,071.52 | Professional | None | $501.19 | $645.65 | $1,071.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $7,413.10 Typical High $18,620.87 | Facility | None | $5,623.41 | $7,413.10 | $18,620.87 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,786.30 | Facility | None | $831.76 | $831.76 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,148.15 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $2,041.74 | Professional | None | $512.86 | $794.33 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $2,691.53 | Facility | None | $426.58 | $660.69 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,071.52 | Professional | None | $501.19 | $645.65 | $1,071.52 |
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 $436.52 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $977.24 | Professional | 54 · Surgery only | $457.09 | $588.84 | $977.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $66.07 Typical High $107.15 | Professional | 55 · Aftercare only | $50.12 | $66.07 | $107.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $66.07 Typical High $107.15 | Professional | 56 · Pre-op care only | $50.12 | $66.07 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $870.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $501.19 Typical High $758.58 | Professional | 53 · Discontinued | $380.19 | $501.19 | $758.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $977.24 | Professional | 54 · Surgery only | $457.09 | $588.84 | $977.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $66.07 Typical High $147.91 | Professional | 55 · Aftercare only | $50.12 | $66.07 | $147.91 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $66.07 Typical High $147.91 | Professional | 56 · Pre-op care only | $50.12 | $66.07 | $147.91 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $870.96 |
Where New York sits
The same service costs 7.9 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· 48th of 51
$759
OK $4,169UT $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.