How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,318 to $10,471Professionalmedian $933 · 10th to 90th $741 to $1,905
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 $5,370.32 Typical High $9,772.37 | Facility | None | $1,659.59 | $5,370.32 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,174.90 | $2,570.40 |
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 $794.33 Median $933.25 Typical High $1,737.80 | Professional | None | $794.33 | $933.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $588.84 Typical High $1,071.52 | Professional | 62 · Two surgeons | $501.19 | $588.84 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $275.42 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $239.88 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $239.88 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,548.82 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $3,890.45 | Professional | None | $831.76 | $1,047.13 | $3,890.45 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $3,548.13 | Facility | None | $1,000.00 | $1,380.38 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $933.25 | $1,071.52 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,412.54 | Professional | None | $660.69 | $831.76 | $1,412.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $13,182.57 | Facility | None | $7,244.36 | $7,244.36 | $13,182.57 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $4,786.30 | Facility | None | $1,071.52 | $1,071.52 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,479.11 | $2,398.83 |
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 $660.69 Median $1,000.00 Typical High $2,630.27 | Professional | None | $660.69 | $1,000.00 | $2,630.27 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $851.14 Typical High $3,467.37 | Facility | None | $562.34 | $851.14 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,412.54 | Professional | None | $660.69 | $831.76 | $1,412.54 |
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 $588.84 Median $588.84 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $758.58 Typical High $1,288.25 | Professional | 54 · Surgery only | $588.84 | $758.58 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $83.18 Typical High $144.54 | Professional | 55 · Aftercare only | $66.07 | $83.18 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $83.18 Typical High $144.54 | Professional | 56 · Pre-op care only | $66.07 | $83.18 | $144.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $676.08 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $524.81 | $676.08 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $645.65 Typical High $977.24 | Professional | 53 · Discontinued | $501.19 | $645.65 | $977.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $588.84 | $776.25 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $85.11 Typical High $190.55 | Professional | 55 · Aftercare only | $66.07 | $85.11 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $676.08 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $524.81 | $676.08 | $1,122.02 |
Where New York sits
The same service costs 5.9 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· 49th of 51
$977
OK $4,074UT $692
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.