How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,318 to $10,233Professionalmedian $501 · 10th to 90th $417 to $1,072
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
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 $416.87 Median $489.78 Typical High $562.34 | Professional | None | $416.87 | $489.78 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $309.03 Typical High $354.81 | Professional | 62 · Two surgeons | $263.03 | $309.03 | $354.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $77.62 Typical High $91.20 | Professional | 80 · Assistant surgeon | $66.07 | $77.62 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $69.18 Typical High $79.43 | Professional | AS · PA/NP assist | $58.88 | $69.18 | $79.43 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $16,595.87 | Facility | None | $2,290.87 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,348.96 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $2,187.76 | Professional | None | $512.86 | $616.60 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,548.13 | Facility | None | $1,445.44 | $1,949.84 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,318.26 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $794.33 | Professional | None | $371.54 | $489.78 | $794.33 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,047.13 | Professional | None | $398.11 | $398.11 | $1,047.13 |
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 $467.74 Median $741.31 Typical High $1,819.70 | Professional | None | $467.74 | $741.31 | $1,819.70 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $416.87 Typical High $1,737.80 | Facility | None | $316.23 | $416.87 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $794.33 | Professional | None | $371.54 | $489.78 | $794.33 |
14 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 $346.74 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $446.68 Typical High $794.33 | Professional | 54 · Surgery only | $338.84 | $446.68 | $794.33 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $48.98 Typical High $89.13 | Professional | 55 · Aftercare only | $37.15 | $48.98 | $89.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $48.98 Typical High $89.13 | Professional | 56 · Pre-op care only | $37.15 | $48.98 | $89.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $398.11 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $302.00 | $398.11 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $446.68 Typical High $724.44 | Professional | 54 · Surgery only | $338.84 | $446.68 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $48.98 Typical High $109.65 | Professional | 55 · Aftercare only | $37.15 | $48.98 | $109.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $48.98 Typical High $109.65 | Professional | 56 · Pre-op care only | $37.15 | $48.98 | $109.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $398.11 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $302.00 | $398.11 | $645.65 |
Where New York sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 51st of 51
$513
OK $3,802NY $513
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.