How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,175 to $8,318Professionalmedian $912 · 10th to 90th $724 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 $1,819.70 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 $1,122.02 Median $1,122.02 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,122.02 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,659.59 | Professional | None | $776.25 | $912.01 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $1,047.13 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $269.15 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $234.42 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $234.42 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,513.56 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $3,715.35 | Professional | None | $812.83 | $1,023.29 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,513.56 Typical High $3,467.37 | Facility | None | $977.24 | $1,513.56 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,698.24 | Professional | None | $912.01 | $1,047.13 | $1,698.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,348.96 | Professional | None | $630.96 | $812.83 | $1,348.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $6,309.57 Typical High $9,120.11 | Facility | None | $5,888.44 | $6,309.57 | $9,120.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,786.30 | Facility | None | $1,047.13 | $1,047.13 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,380.38 | $2,344.23 |
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 $645.65 Median $977.24 Typical High $2,570.40 | Professional | None | $645.65 | $977.24 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $831.76 Typical High $3,388.44 | Facility | None | $537.03 | $831.76 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,288.25 | Professional | None | $630.96 | $812.83 | $1,288.25 |
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 $562.34 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $741.31 Typical High $1,230.27 | Professional | 54 · Surgery only | $575.44 | $741.31 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $134.90 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $81.28 Typical High $134.90 | Professional | 56 · Pre-op care only | $63.10 | $81.28 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $645.65 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $512.86 | $645.65 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $630.96 Typical High $954.99 | Professional | 53 · Discontinued | $489.78 | $630.96 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $741.31 Typical High $1,148.15 | Professional | 54 · Surgery only | $575.44 | $741.31 | $1,148.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $83.18 Typical High $186.21 | Professional | 55 · Aftercare only | $63.10 | $83.18 | $186.21 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $83.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $63.10 | $83.18 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $660.69 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $512.86 | $660.69 | $1,023.29 |
Where New York sits
The same service costs 6.2 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· 48th of 51
$955
OK $4,074UT $661
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.