How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $14,125Professionalmedian $741 · 10th to 90th $589 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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,819.70 | Professional | None | $660.69 | $912.01 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,348.96 | Professional | None | $602.56 | $707.95 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $446.68 Typical High $851.14 | Professional | 62 · Two surgeons | $380.19 | $446.68 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $218.78 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $190.55 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $190.55 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,445.44 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $2,691.53 | Professional | None | $724.44 | $870.96 | $2,691.53 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,818.38 | Facility | None | $794.33 | $1,258.93 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,380.38 | Professional | None | $776.25 | $851.14 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,071.52 | Professional | None | $524.81 | $691.83 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $4,786.30 | Facility | None | $812.83 | $812.83 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,071.52 | $2,089.30 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,949.84 | Professional | None | $562.34 | $954.99 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $691.83 Typical High $2,691.53 | Facility | None | $562.34 | $691.83 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,000.00 | Professional | None | $524.81 | $691.83 | $1,000.00 |
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 $331.13 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $331.13 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $131.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $501.19 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $100.00 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $66.07 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $467.74 | $645.65 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $977.24 | Professional | 54 · Surgery only | $446.68 | $575.44 | $977.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $158.49 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $158.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $134.90 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $489.78 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $389.05 | $489.78 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $512.86 Typical High $776.25 | Professional | 53 · Discontinued | $389.05 | $512.86 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $870.96 | Professional | 54 · Surgery only | $446.68 | $575.44 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $95.50 Typical High $208.93 | Professional | 55 · Aftercare only | $72.44 | $95.50 | $208.93 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $81.28 Typical High $181.97 | Professional | 56 · Pre-op care only | $61.66 | $81.28 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $501.19 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $389.05 | $501.19 | $741.31 |
Where New York sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$759
OK $3,548TX $525
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.