How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,288 to $12,589Professionalmedian $575 · 10th to 90th $437 to $1,202
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,659.59 | Professional | None | $630.96 | $630.96 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $1,071.52 | Professional | None | $467.74 | $549.54 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $346.74 Typical High $676.08 | Professional | 62 · Two surgeons | $295.12 | $346.74 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $169.82 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $147.91 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $147.91 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,348.96 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $2,290.87 | Professional | None | $467.74 | $724.44 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $724.44 Typical High $2,187.76 | Facility | None | $616.60 | $724.44 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,071.52 | Professional | None | $562.34 | $645.65 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $758.58 | Professional | None | $407.38 | $524.81 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $4,786.30 | Facility | None | $602.56 | $602.56 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,445.44 | Professional | None | $645.65 | $645.65 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,548.82 | Professional | None | $426.58 | $691.83 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $537.03 Typical High $1,995.26 | Facility | None | $316.23 | $537.03 | $1,995.26 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $707.95 | Professional | None | $407.38 | $524.81 | $707.95 |
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 $316.23 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $457.09 Typical High $691.83 | Professional | 54 · Surgery only | $371.54 | $457.09 | $691.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $45.71 Typical High $67.61 | Professional | 55 · Aftercare only | $36.31 | $45.71 | $67.61 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $67.61 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $67.61 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $331.13 | $416.87 | $616.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $398.11 Typical High $602.56 | Professional | 53 · Discontinued | $295.12 | $398.11 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $478.63 Typical High $645.65 | Professional | 54 · Surgery only | $371.54 | $478.63 | $645.65 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $104.71 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $104.71 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $104.71 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $104.71 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $426.58 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $331.13 | $426.58 | $575.44 |
Where New York sits
The same service costs 8.1 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
$589
OK $3,467UT $427
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.