How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,000Professionalmedian $676 · 10th to 90th $550 to $1,413
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,819.70 | Professional | None | $891.25 | $891.25 | $1,819.70 |
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 $676.08 Typical High $1,258.93 | Professional | None | $575.44 | $676.08 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $426.58 Typical High $794.33 | Professional | 62 · Two surgeons | $363.08 | $426.58 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $204.17 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $177.83 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $177.83 |
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 $1,000.00 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 $1,318.26 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 $616.60 Median $758.58 Typical High $2,754.23 | Professional | None | $616.60 | $758.58 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,691.53 | Facility | None | $758.58 | $1,023.29 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,318.26 | Professional | None | $691.83 | $794.33 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $4,786.30 | Facility | None | $741.31 | $741.31 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,096.48 | $1,778.28 |
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 $501.19 Median $741.31 Typical High $1,905.46 | Professional | None | $501.19 | $741.31 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $2,511.89 | Facility | None | $407.38 | $630.96 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $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 $446.68 Median $446.68 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $1,047.13 | Professional | 54 · Surgery only | $436.52 | $562.34 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $114.82 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $114.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $114.82 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $501.19 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $389.05 | $501.19 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $478.63 Typical High $724.44 | Professional | 53 · Discontinued | $363.08 | $478.63 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $933.25 | Professional | 54 · Surgery only | $436.52 | $562.34 | $933.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $141.25 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $141.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $63.10 Typical High $141.25 | Professional | 56 · Pre-op care only | $47.86 | $63.10 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $501.19 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $389.05 | $501.19 | $831.76 |
Where New York sits
The same service costs 7.2 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· 49th of 51
$724
OK $3,802UT $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.