How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,318 to $11,482Professionalmedian $912 · 10th to 90th $724 to $1,862
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 $5,370.32 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,370.32 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,258.93 | $2,570.40 |
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 $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 $7,943.28 Typical High $16,218.10 | Facility | None | $1,513.56 | $7,943.28 | $16,218.10 |
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 $954.99 Median $1,047.13 Typical High $1,698.24 | Professional | None | $954.99 | $1,047.13 | $1,698.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Facility | None | $14,791.08 | $14,791.08 | $14,791.08 |
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 $1,348.96 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,548.82 | $2,344.23 |
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 $645.65 Median $1,000.00 Typical High $2,570.40 | Professional | None | $645.65 | $1,000.00 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $831.76 Typical High $3,890.45 | Facility | None | $537.03 | $831.76 | $3,890.45 |
Univera Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
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 $616.60 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $891.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $741.31 Typical High $1,258.93 | Professional | 54 · Surgery only | $575.44 | $741.31 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $81.28 Typical High $141.25 | Professional | 55 · Aftercare only | $64.57 | $81.28 | $141.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $81.28 Typical High $141.25 | Professional | 56 · Pre-op care only | $64.57 | $81.28 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $660.69 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $512.86 | $660.69 | $1,122.02 |
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 $1,230.27 | Professional | 54 · Surgery only | $575.44 | $741.31 | $1,230.27 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $186.21 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $186.21 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $660.69 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $512.86 | $660.69 | $1,096.48 |
Where New York sits
The same service costs 6.3 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
$955
OK $4,169UT $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.