How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,047 to $7,586Professionalmedian $603 · 10th to 90th $490 to $912
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | None | $776.25 | $776.25 | $870.96 |
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 $512.86 Median $602.56 Typical High $870.96 | Professional | None | $512.86 | $602.56 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $891.25 Typical High $1,288.25 | Professional | 50 · Both sides | $758.58 | $891.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $380.19 Typical High $537.03 | Professional | 62 · Two surgeons | $323.59 | $380.19 | $537.03 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,715.35 | Facility | None | $1,148.15 | $1,819.70 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $1,445.44 | Professional | None | $512.86 | $537.03 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $2,238.72 | Facility | None | $549.54 | $707.95 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,023.29 | Professional | None | $575.44 | $660.69 | $1,023.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $851.14 | Professional | None | $331.13 | $537.03 | $851.14 |
MVP Health Care Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $5,754.40 | Facility | None | $602.56 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | None | $794.33 | $794.33 | $912.01 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,000.00 | Professional | None | $436.52 | $645.65 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $2,089.30 | Facility | None | $575.44 | $616.60 | $2,089.30 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $851.14 | Professional | None | $331.13 | $537.03 | $851.14 |
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 $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $616.60 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $676.08 | Professional | 54 · Surgery only | $363.08 | $436.52 | $676.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $169.82 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $85.11 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $85.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $588.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $416.87 Typical High $575.44 | Professional | 53 · Discontinued | $331.13 | $416.87 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $363.08 | $446.68 | $676.08 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $275.42 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $323.59 | $398.11 | $588.84 |
Where New York sits
The same service costs 3.2 times more in Oklahoma than in Maryland. 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.
Physician feeFacility fee
OK $5,853MD $1,833
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.