How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,318 to $11,749Professionalmedian $794 · 10th to 90th $603 to $1,698
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $2,290.87 | Professional | None | $776.25 | $954.99 | $2,290.87 |
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 $645.65 Median $758.58 Typical High $1,513.56 | Professional | None | $645.65 | $758.58 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $954.99 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $245.47 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $213.80 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $213.80 |
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 $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 $977.24 Median $1,047.13 Typical High $3,162.28 | Professional | None | $977.24 | $1,047.13 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $2,041.74 Typical High $3,890.45 | Facility | None | $891.25 | $2,041.74 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,584.89 | Professional | None | $870.96 | $954.99 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,071.52 | Professional | None | $467.74 | $691.83 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,786.30 | Facility | None | $831.76 | $831.76 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,698.24 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $14,125.38 | Facility | None | $1,230.27 | $3,090.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $2,187.76 | Professional | None | $630.96 | $977.24 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $776.25 Typical High $2,754.23 | Facility | None | $691.83 | $776.25 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $977.24 | Professional | None | $467.74 | $691.83 | $977.24 |
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 $389.05 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $851.14 | Professional | 54 · Surgery only | $446.68 | $524.81 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $251.19 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $251.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $407.38 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $346.74 | $407.38 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $562.34 Typical High $812.83 | Professional | 53 · Discontinued | $407.38 | $562.34 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $812.83 | Professional | 54 · Surgery only | $446.68 | $524.81 | $812.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $363.08 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $363.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $269.15 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $407.38 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $346.74 | $407.38 | $776.25 |
Where New York sits
The same service costs 8.5 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· 45th of 51
$813
OK $3,162TX $372
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.