How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,380 to $14,791Professionalmedian $724 · 10th to 90th $589 to $1,622
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 $6,309.57 Typical High $13,489.63 | Facility | None | $1,819.70 | $6,309.57 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,454.71 | Professional | None | $707.95 | $1,000.00 | $2,454.71 |
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 $588.84 Median $691.83 Typical High $1,513.56 | Professional | None | $588.84 | $691.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $239.88 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $208.93 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $208.93 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $8,511.38 Typical High $17,782.79 | Facility | None | $1,445.44 | $8,511.38 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $3,019.95 | Professional | None | $776.25 | $933.25 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $3,311.31 | Facility | None | $776.25 | $1,288.25 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,479.11 | Professional | None | $724.44 | $891.25 | $1,479.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,148.15 | Professional | None | $549.54 | $741.31 | $1,148.15 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $6,456.54 Typical High $7,079.46 | Facility | None | $1,000.00 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,819.70 | Professional | None | $707.95 | $707.95 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $2,137.96 | Professional | None | $602.56 | $1,047.13 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $1,318.26 | Facility | None | $588.84 | $741.31 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,071.52 | Professional | None | $549.54 | $741.31 | $1,071.52 |
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 $354.81 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $537.03 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $501.19 | $707.95 | $707.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $1,023.29 | Professional | 54 · Surgery only | $467.74 | $588.84 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $100.00 Typical High $165.96 | Professional | 55 · Aftercare only | $75.86 | $100.00 | $165.96 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $141.25 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $870.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $562.34 Typical High $831.76 | Professional | 53 · Discontinued | $416.87 | $562.34 | $831.76 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $616.60 Typical High $1,000.00 | Professional | 54 · Surgery only | $467.74 | $616.60 | $1,000.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $100.00 Typical High $223.87 | Professional | 55 · Aftercare only | $75.86 | $100.00 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $851.14 |
Where New York sits
The same service costs 11.0 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· 49th of 51
$759
OK $5,888UT $537
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.