How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,479 to $18,621Professionalmedian $1,096 · 10th to 90th $871 to $2,291
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 $2,570.40 Median $7,079.46 Typical High $15,135.61 | Facility | None | $2,570.40 | $7,079.46 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $3,630.78 | Professional | None | $977.24 | $1,412.54 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,912.51 Typical High $23,442.29 | Facility | None | $1,737.80 | $8,912.51 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,089.30 | Professional | None | $891.25 | $1,047.13 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,318.26 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $331.13 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $288.40 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $288.40 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $8,317.64 Typical High $17,378.01 | Facility | None | $1,737.80 | $8,317.64 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $4,168.69 | Professional | None | $1,071.52 | $1,174.90 | $4,168.69 |
Emblem Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $4,073.80 | Facility | None | $1,174.90 | $2,344.23 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,258.93 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,584.89 | Professional | None | $758.58 | $1,000.00 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,174.90 Median $7,079.46 Typical High $12,882.50 | Facility | None | $1,174.90 | $7,079.46 | $12,882.50 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,479.11 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $2,951.21 | Professional | None | $812.83 | $1,445.44 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $3,890.45 | Facility | None | $812.83 | $1,023.29 | $3,890.45 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,445.44 | Professional | None | $758.58 | $1,000.00 | $1,445.44 |
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 $489.78 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $489.78 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $194.98 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $724.44 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $97.72 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $676.08 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $812.83 Typical High $1,412.54 | Professional | 54 · Surgery only | $645.65 | $812.83 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $131.83 Typical High $229.09 | Professional | 55 · Aftercare only | $104.71 | $131.83 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $194.98 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $691.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $562.34 | $691.83 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Professional | 53 · Discontinued | $575.44 | $776.25 | $1,122.02 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $831.76 Typical High $1,380.38 | Professional | 54 · Surgery only | $645.65 | $831.76 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $138.04 Typical High $309.03 | Professional | 55 · Aftercare only | $104.71 | $138.04 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $117.49 Typical High $263.03 | Professional | 56 · Pre-op care only | $91.20 | $117.49 | $263.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $724.44 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $562.34 | $724.44 | $1,174.90 |
Where New York sits
The same service costs 8.7 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· 46th of 51
$1,148
OK $6,166TX $708
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.