How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,230 to $11,220Professionalmedian $676 · 10th to 90th $537 to $1,445
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,905.46 | Professional | None | $616.60 | $851.14 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,318.26 | Professional | None | $549.54 | $645.65 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $407.38 Typical High $831.76 | Professional | 62 · Two surgeons | $346.74 | $407.38 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $102.33 Typical High $208.93 | Professional | 80 · Assistant surgeon | $87.10 | $102.33 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $186.21 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $186.21 |
CDPHP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $2,691.53 | Professional | None | $691.83 | $851.14 | $2,691.53 |
Emblem Health Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $2,570.40 | Facility | None | $676.08 | $870.96 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,288.25 | Professional | None | $724.44 | $794.33 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $4,786.30 | Facility | None | $724.44 | $724.44 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,737.80 | Professional | None | $851.14 | $851.14 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,862.09 | Professional | None | $524.81 | $891.25 | $1,862.09 |
Univera Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $2,454.71 | Facility | None | $512.86 | $645.65 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $933.25 | Professional | None | $478.63 | $616.60 | $933.25 |
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 $309.03 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $123.03 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $891.25 | Professional | 54 · Surgery only | $407.38 | $512.86 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $144.54 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $72.44 Typical High $125.89 | Professional | 56 · Pre-op care only | $57.54 | $72.44 | $125.89 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $446.68 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $354.81 | $446.68 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $478.63 Typical High $724.44 | Professional | 53 · Discontinued | $363.08 | $478.63 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $537.03 Typical High $870.96 | Professional | 54 · Surgery only | $407.38 | $537.03 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $194.98 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $165.96 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $354.81 | $457.09 | $741.31 |
Where New York sits
The same service costs 6.9 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· 43rd of 51
$724
OK $3,020TX $437
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.