How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,175 to $9,333Professionalmedian $871 · 10th to 90th $646 to $1,549
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 $794.33 Median $794.33 Typical High $2,187.76 | Professional | None | $794.33 | $794.33 | $2,187.76 |
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 $724.44 Median $870.96 Typical High $1,548.82 | Professional | None | $724.44 | $870.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,288.25 Typical High $2,290.87 | Professional | 50 · Both sides | $1,096.48 | $1,288.25 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $549.54 Typical High $954.99 | Professional | 62 · Two surgeons | $467.74 | $549.54 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $245.47 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $213.80 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $213.80 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,479.11 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $1,905.46 | Professional | None | $602.56 | $1,148.15 | $1,905.46 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $1,023.29 Typical High $3,311.31 | Facility | None | $660.69 | $1,023.29 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,737.80 | Professional | None | $912.01 | $1,000.00 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,096.48 | Professional | None | $630.96 | $758.58 | $1,096.48 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | 50 · Both sides | $5,248.07 | $5,248.07 | $5,248.07 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,071.52 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,548.82 | Professional | None | $524.81 | $870.96 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $831.76 Typical High $3,090.30 | Facility | None | $691.83 | $831.76 | $3,090.30 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,096.48 | Professional | None | $630.96 | $794.33 | $1,096.48 |
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 $398.11 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $660.69 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $512.86 | $645.65 | $870.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $79.43 Typical High $109.65 | Professional | 56 · Pre-op care only | $63.10 | $79.43 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $446.68 | $575.44 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $602.56 Typical High $707.95 | Professional | 53 · Discontinued | $478.63 | $602.56 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $512.86 | $645.65 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $234.42 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $79.43 Typical High $123.03 | Professional | 56 · Pre-op care only | $63.10 | $79.43 | $123.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $575.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $446.68 | $575.44 | $831.76 |
Where New York sits
The same service costs 3.5 times more in Wisconsin 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
WI $7,760MD $2,222
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.