How much rates vary
Facilitymedian $3,467 · 10th to 90th $871 to $7,762Professionalmedian $288 · 10th to 90th $224 to $759
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 $398.11 Median $4,897.79 Typical High $9,549.93 | Facility | None | $398.11 | $4,897.79 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $870.96 | Professional | None | $295.12 | $380.19 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $602.56 | Professional | None | $223.87 | $263.03 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $41.69 Typical High $95.50 | Professional | 80 · Assistant surgeon | $35.48 | $41.69 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $36.31 Typical High $83.18 | Professional | AS · PA/NP assist | $30.90 | $36.31 | $83.18 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,318.26 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $1,230.27 | Professional | None | $323.59 | $398.11 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $354.81 Typical High $1,174.90 | Facility | None | $100.00 | $354.81 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $616.60 | Professional | None | $346.74 | $380.19 | $616.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $478.63 | Professional | None | $223.87 | $309.03 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $467.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $467.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $812.83 | Professional | None | $457.09 | $758.58 | $812.83 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $851.14 | Professional | None | $245.47 | $416.87 | $851.14 |
Univera Setting Facility Modifier None Typical Low $245.47 Median $309.03 Typical High $1,174.90 | Facility | None | $245.47 | $309.03 | $1,174.90 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $436.52 | Professional | None | $223.87 | $309.03 | $436.52 |
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 $147.91 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $58.88 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $204.17 | $263.03 | $263.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $245.47 Typical High $426.58 | Professional | 54 · Surgery only | $194.98 | $245.47 | $426.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $39.81 Typical High $69.18 | Professional | 55 · Aftercare only | $31.62 | $39.81 | $69.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $26.92 | $33.88 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | 53 · Discontinued | $165.96 | $218.78 | $338.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $389.05 | Professional | 54 · Surgery only | $194.98 | $251.19 | $389.05 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $91.20 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $91.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $35.48 Typical High $79.43 | Professional | 56 · Pre-op care only | $26.92 | $35.48 | $79.43 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $165.96 | $218.78 | $338.84 |
Where New York sits
The same service costs 11.2 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
$295
OK $2,512UT $224
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.