How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,349 to $10,000Professionalmedian $1,413 · 10th to 90th $1,096 to $2,570
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 $1,318.26 Median $5,128.61 Typical High $11,481.54 | Facility | None | $1,318.26 | $5,128.61 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,318.26 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,445.44 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,659.59 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $371.54 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $371.54 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $6,309.57 | Facility | None | $1,778.28 | $3,235.94 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,819.70 | $2,691.53 |
Emblem Health Setting Facility Modifier None Typical Low $851.14 Median $1,659.59 Typical High $5,370.32 | Facility | None | $851.14 | $1,659.59 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,659.59 | $3,467.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,318.26 | $1,737.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,348.96 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,570.40 | Professional | None | $870.96 | $1,445.44 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $5,248.07 | Facility | None | $1,096.48 | $1,380.38 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,318.26 | $1,737.80 |
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 $575.44 Median $660.69 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,071.52 Typical High $1,412.54 | Professional | 54 · Surgery only | $812.83 | $1,071.52 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $331.13 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $131.83 Typical High $173.78 | Professional | 56 · Pre-op care only | $100.00 | $131.83 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $933.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $707.95 | $933.25 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,000.00 Typical High $1,174.90 | Professional | 53 · Discontinued | $776.25 | $1,000.00 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,071.52 Typical High $1,412.54 | Professional | 54 · Surgery only | $812.83 | $1,071.52 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $371.54 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $131.83 Typical High $194.98 | Professional | 56 · Pre-op care only | $100.00 | $131.83 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $707.95 | $933.25 | $1,380.38 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Hawaii. 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
AK $10,812HI $3,105
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.