How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $10,233Professionalmedian $468 · 10th to 90th $380 to $977
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,288.25 | Professional | None | $575.44 | $575.44 | $1,288.25 |
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 $398.11 Median $467.74 Typical High $870.96 | Professional | None | $398.11 | $467.74 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $707.95 Typical High $1,318.26 | Professional | 50 · Both sides | $602.56 | $707.95 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $75.86 Typical High $141.25 | Professional | 80 · Assistant surgeon | $64.57 | $75.86 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $66.07 Typical High $123.03 | Professional | AS · PA/NP assist | $56.23 | $66.07 | $123.03 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,951.21 Typical High $5,888.44 | Facility | None | $1,348.96 | $2,951.21 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $1,949.84 | Professional | None | $426.58 | $562.34 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $1,862.09 | Facility | None | $524.81 | $707.95 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $912.01 | Professional | None | $489.78 | $549.54 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $707.95 | Professional | None | $331.13 | $436.52 | $707.95 |
MVP Health Care Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,786.30 | Facility | None | $537.03 | $537.03 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,230.27 | Professional | None | $660.69 | $660.69 | $1,230.27 |
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 $346.74 Median $512.86 Typical High $1,318.26 | Professional | None | $346.74 | $512.86 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $1,584.89 | Facility | None | $281.84 | $436.52 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $707.95 | Professional | None | $331.13 | $436.52 | $707.95 |
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 $288.40 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $117.49 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $446.68 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $724.44 | Professional | 54 · Surgery only | $302.00 | $389.05 | $724.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $79.43 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $79.43 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $79.43 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $79.43 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $346.74 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $269.15 | $346.74 | $630.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $331.13 Typical High $501.19 | Professional | 53 · Discontinued | $251.19 | $331.13 | $501.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $645.65 | Professional | 54 · Surgery only | $302.00 | $389.05 | $645.65 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $97.72 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $97.72 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $97.72 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $97.72 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $346.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $269.15 | $346.74 | $575.44 |
Where New York sits
The same service costs 10.0 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
$501
OK $3,631UT $363
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.