How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,549 to $14,125Professionalmedian $1,778 · 10th to 90th $1,413 to $2,818
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 $1,995.26 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,995.26 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,862.09 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,778.28 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,122.02 Typical High $1,318.26 | Professional | 62 · Two surgeons | $954.99 | $1,122.02 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $331.13 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $251.19 Typical High $295.12 | Professional | AS · PA/NP assist | $213.80 | $251.19 | $295.12 |
CDPHP Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,737.80 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,698.24 | $1,698.24 | $3,890.45 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $6,606.93 | Facility | None | $1,819.70 | $2,187.76 | $6,606.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,995.26 | $3,019.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $2,187.76 | Professional | None | $933.25 | $1,584.89 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $2,187.76 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,187.76 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,659.59 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $4,073.80 | Professional | None | $1,202.26 | $1,819.70 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,951.21 | Facility | None | $1,096.48 | $1,548.82 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,584.89 | $2,187.76 |
12 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 |
|---|---|---|---|---|---|
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,288.25 Typical High $1,862.09 | Professional | 54 · Surgery only | $758.58 | $1,288.25 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $302.00 Typical High $436.52 | Professional | 55 · Aftercare only | $177.83 | $302.00 | $436.52 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $158.49 Typical High $229.09 | Professional | 56 · Pre-op care only | $93.33 | $158.49 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,122.02 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $660.69 | $1,122.02 | $1,659.59 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $891.25 Median $1,584.89 Typical High $1,905.46 | Facility | 54 · Surgery only | $891.25 | $1,584.89 | $1,905.46 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $208.93 Median $371.54 Typical High $446.68 | Facility | 55 · Aftercare only | $208.93 | $371.54 | $446.68 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $109.65 Median $218.78 Typical High $234.42 | Facility | 56 · Pre-op care only | $109.65 | $218.78 | $234.42 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,412.54 Typical High $1,659.59 | Facility | 78 · Unplanned return to OR | $776.25 | $1,412.54 | $1,659.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,288.25 Typical High $1,737.80 | Professional | 54 · Surgery only | $758.58 | $1,288.25 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $302.00 Typical High $794.33 | Professional | 55 · Aftercare only | $177.83 | $302.00 | $794.33 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $158.49 Typical High $416.87 | Professional | 56 · Pre-op care only | $93.33 | $158.49 | $416.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,122.02 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $660.69 | $1,122.02 | $1,548.82 |
Where New York sits
The same service costs 4.7 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 $16,761KY $3,555
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.