How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,288 to $12,882Professionalmedian $380 · 10th to 90th $316 to $871
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 $1,905.46 Median $6,456.54 Typical High $13,182.57 | Facility | None | $1,905.46 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,288.25 | Professional | None | $501.19 | $501.19 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $758.58 | Professional | None | $316.23 | $371.54 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $562.34 Typical High $1,148.15 | Professional | 50 · Both sides | $478.63 | $562.34 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $234.42 Typical High $478.63 | Professional | 62 · Two surgeons | $199.53 | $234.42 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $60.26 Typical High $123.03 | Professional | 80 · Assistant surgeon | $51.29 | $60.26 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $52.48 Typical High $107.15 | Professional | AS · PA/NP assist | $44.67 | $52.48 | $107.15 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,238.72 | $5,128.61 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $1,698.24 | Professional | None | $371.54 | $537.03 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $457.09 Median $676.08 Typical High $1,621.81 | Facility | None | $457.09 | $676.08 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $794.33 | Professional | None | $426.58 | $489.78 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $630.96 | Professional | None | $295.12 | $380.19 | $630.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $6,456.54 Typical High $7,079.46 | Facility | None | $457.09 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,071.52 | Professional | None | $537.03 | $537.03 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,168.69 | $13,182.57 |
United Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $1,148.15 | Professional | None | $302.00 | $446.68 | $1,148.15 |
Univera Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $1,479.11 | Facility | None | $251.19 | $380.19 | $1,479.11 |
Univera Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $630.96 | Professional | None | $295.12 | $380.19 | $630.96 |
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 $251.19 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $389.05 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $346.74 Typical High $630.96 | Professional | 54 · Surgery only | $263.03 | $346.74 | $630.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $69.18 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $69.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $69.18 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $69.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $302.00 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $234.42 | $302.00 | $562.34 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $288.40 Typical High $436.52 | Professional | 53 · Discontinued | $218.78 | $288.40 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $346.74 Typical High $562.34 | Professional | 54 · Surgery only | $263.03 | $346.74 | $562.34 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $85.11 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $85.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $85.11 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $85.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $309.03 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $234.42 | $309.03 | $501.19 |
Where New York sits
The same service costs 9.5 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
$407
OK $3,236UT $339
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.