How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,288 to $11,749Professionalmedian $646 · 10th to 90th $513 to $1,047
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $724.44 | Professional | None | $660.69 | $691.83 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $891.25 | Professional | None | $549.54 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $407.38 Typical High $562.34 | Professional | 62 · Two surgeons | $346.74 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $102.33 Typical High $141.25 | Professional | 80 · Assistant surgeon | $87.10 | $102.33 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $123.03 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $123.03 |
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 $1,445.44 Median $6,456.54 Typical High $12,882.50 | Facility | None | $1,445.44 | $6,456.54 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,445.44 | Professional | None | $588.84 | $588.84 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $2,454.71 | Facility | None | $691.83 | $870.96 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,071.52 | Professional | None | $562.34 | $707.95 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $831.76 | Professional | None | $363.08 | $562.34 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $741.31 Median $4,786.30 Typical High $5,754.40 | Facility | None | $741.31 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,584.89 | Professional | None | $660.69 | $870.96 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $1,479.11 | Professional | None | $416.87 | $630.96 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $562.34 Typical High $3,235.94 | Facility | None | $426.58 | $562.34 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | None | $426.58 | $562.34 | $831.76 |
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 $323.59 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $457.09 | $478.63 | $478.63 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $707.95 | Professional | 54 · Surgery only | $281.84 | $446.68 | $707.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $186.21 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $89.13 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $89.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $616.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $489.78 | Professional | 53 · Discontinued | $331.13 | $338.84 | $489.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $446.68 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $338.84 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $158.49 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $575.44 |
Where New York sits
The same service costs 5.2 times more in Alaska 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
AK $9,591KY $1,851
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.