How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,000 to $7,586Professionalmedian $251 · 10th to 90th $200 to $646
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $831.76 | Professional | None | $251.19 | $331.13 | $831.76 |
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 $199.53 Median $234.42 Typical High $537.03 | Professional | None | $199.53 | $234.42 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $354.81 Typical High $794.33 | Professional | 50 · Both sides | $302.00 | $354.81 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $125.89 Median $147.91 Typical High $323.59 | Professional | 62 · Two surgeons | $125.89 | $147.91 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $38.02 Typical High $83.18 | Professional | 80 · Assistant surgeon | $32.36 | $38.02 | $83.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $33.11 Typical High $74.13 | Professional | AS · PA/NP assist | $28.18 | $33.11 | $74.13 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $1,096.48 | Professional | None | $281.84 | $363.08 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $1,148.15 | Facility | None | $302.00 | $575.44 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $524.81 | Professional | None | $302.00 | $331.13 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $724.44 | Professional | None | $208.93 | $251.19 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $707.95 | Professional | None | $363.08 | $363.08 | $707.95 |
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 $213.80 Median $363.08 Typical High $758.58 | Professional | None | $213.80 | $363.08 | $758.58 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $2,137.96 | Facility | None | $208.93 | $338.84 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $707.95 | Professional | None | $177.83 | $251.19 | $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 $125.89 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $177.83 | $234.42 | $234.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $676.08 | Professional | 54 · Surgery only | $186.21 | $229.09 | $676.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $24.55 Typical High $42.66 | Professional | 55 · Aftercare only | $19.50 | $24.55 | $42.66 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $42.66 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $42.66 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $204.17 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $165.96 | $204.17 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $194.98 Typical High $295.12 | Professional | 53 · Discontinued | $144.54 | $194.98 | $295.12 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $229.09 Typical High $660.69 | Professional | 54 · Surgery only | $162.18 | $229.09 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $40.74 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $40.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $40.74 | Professional | 56 · Pre-op care only | $17.78 | $24.55 | $40.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $602.56 |
Where New York sits
The same service costs 6.0 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· 50th of 51
$263
OK $1,479UT $245
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.