How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,230 to $9,333Professionalmedian $977 · 10th to 90th $794 to $1,660
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 $1,659.59 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,659.59 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,047.13 | $1,174.90 |
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 $812.83 Median $954.99 Typical High $1,348.96 | Professional | None | $812.83 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $213.80 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $190.55 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $190.55 |
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $4,265.80 | Facility | None | $1,548.82 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,290.87 | Professional | None | $977.24 | $977.24 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,548.13 | Facility | None | $645.65 | $1,071.52 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,698.24 | Professional | None | $933.25 | $1,071.52 | $1,698.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,318.26 | Professional | None | $562.34 | $851.14 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,122.02 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,122.02 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,047.13 | $2,137.96 |
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 $645.65 Median $1,023.29 Typical High $2,398.83 | Professional | None | $645.65 | $1,023.29 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $2,951.21 | Facility | None | $676.08 | $933.25 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,318.26 | Professional | None | $676.08 | $851.14 | $1,318.26 |
10 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 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $794.33 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $794.33 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $676.08 Typical High $1,047.13 | Professional | 54 · Surgery only | $446.68 | $676.08 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $275.42 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $275.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $85.11 Typical High $131.83 | Professional | 56 · Pre-op care only | $56.23 | $85.11 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $588.84 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $389.05 | $588.84 | $912.01 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $676.08 Typical High $1,047.13 | Professional | 54 · Surgery only | $446.68 | $676.08 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $549.54 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $549.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $85.11 Typical High $257.04 | Professional | 56 · Pre-op care only | $56.23 | $85.11 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $588.84 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $389.05 | $588.84 | $933.25 |
Where New York sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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 $7,760KY $2,277
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.