How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $7,762Professionalmedian $355 · 10th to 90th $282 to $794
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 $1,513.56 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,513.56 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,023.29 | Professional | None | $323.59 | $446.68 | $1,023.29 |
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 $288.40 Median $338.84 Typical High $691.83 | Professional | None | $288.40 | $338.84 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $213.80 Typical High $436.52 | Professional | 62 · Two surgeons | $181.97 | $213.80 | $436.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $109.65 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $47.86 Typical High $95.50 | Professional | AS · PA/NP assist | $40.74 | $47.86 | $95.50 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,479.11 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $1,380.38 | Professional | None | $354.81 | $467.74 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $588.84 Typical High $1,380.38 | Facility | None | $354.81 | $588.84 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $676.08 | Professional | None | $363.08 | $416.87 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $524.81 | Professional | None | $251.19 | $338.84 | $524.81 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $3,235.94 Typical High $4,365.16 | Facility | None | $691.83 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $933.25 | Professional | None | $524.81 | $794.33 | $933.25 |
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 $275.42 Median $467.74 Typical High $977.24 | Professional | None | $275.42 | $467.74 | $977.24 |
Univera Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $1,584.89 | Facility | None | $269.15 | $338.84 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $489.78 | Professional | None | $251.19 | $338.84 | $489.78 |
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 $162.18 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $162.18 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $64.57 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $239.88 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $316.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $275.42 Typical High $467.74 | Professional | 54 · Surgery only | $213.80 | $275.42 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $75.86 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $75.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.02 Typical High $64.57 | Professional | 56 · Pre-op care only | $30.20 | $38.02 | $64.57 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $398.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $251.19 Typical High $380.19 | Professional | 53 · Discontinued | $186.21 | $251.19 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $457.09 | Professional | 54 · Surgery only | $213.80 | $281.84 | $457.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $102.33 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $102.33 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $87.10 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $87.10 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $389.05 |
Where New York sits
The same service costs 7.1 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· 48th of 51
$380
OK $1,950UT $275
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.