How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,413 to $12,023Professionalmedian $1,950 · 10th to 90th $1,072 to $3,090
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 $5,888.44 Typical High $12,302.69 | Facility | None | $1,819.70 | $5,888.44 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,071.52 | $2,137.96 | $2,344.23 |
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 $1,737.80 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,737.80 | $2,041.74 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,288.25 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,096.48 | $1,288.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $416.87 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $371.54 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $371.54 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,659.59 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $6,309.57 Typical High $12,882.50 | Facility | None | $1,584.89 | $6,309.57 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,949.84 | $4,168.69 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $4,265.80 | Facility | None | $954.99 | $1,348.96 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,454.71 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,862.09 | $2,511.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,023.29 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $5,011.87 | Professional | None | $1,122.02 | $1,122.02 | $5,011.87 |
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 $912.01 Median $1,659.59 Typical High $3,467.37 | Professional | None | $912.01 | $1,659.59 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $4,365.16 | Facility | None | $758.58 | $1,862.09 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,862.09 | $2,511.89 |
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 $537.03 Median $1,071.52 Typical High $1,174.90 | Professional | 52 · Reduced service | $537.03 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $426.58 Typical High $467.74 | Professional | 53 · Discontinued | $213.80 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,584.89 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,584.89 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $323.59 Typical High $354.81 | Professional | 55 · Aftercare only | $162.18 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $213.80 Typical High $234.42 | Professional | 56 · Pre-op care only | $107.15 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,479.11 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $758.58 | $1,479.11 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,479.11 Typical High $1,995.26 | Professional | 54 · Surgery only | $851.14 | $1,479.11 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $398.11 Typical High $524.81 | Professional | 55 · Aftercare only | $229.09 | $398.11 | $524.81 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $186.21 Typical High $251.19 | Professional | 56 · Pre-op care only | $107.15 | $186.21 | $251.19 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,288.25 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $741.31 | $1,288.25 | $1,737.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,122.02 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,096.48 | $1,122.02 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,479.11 Typical High $1,995.26 | Professional | 54 · Surgery only | $851.14 | $1,479.11 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $407.38 Typical High $977.24 | Professional | 55 · Aftercare only | $229.09 | $407.38 | $977.24 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $194.98 Typical High $467.74 | Professional | 56 · Pre-op care only | $107.15 | $194.98 | $467.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,348.96 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $741.31 | $1,348.96 | $1,862.09 |
Where New York sits
The same service costs 3.7 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 $13,607KY $3,727
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.