How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,230 to $10,715Professionalmedian $537 · 10th to 90th $437 to $891
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | None | $562.34 | $562.34 | $645.65 |
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 $436.52 Median $524.81 Typical High $724.44 | Professional | None | $436.52 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $83.18 Typical High $117.49 | Professional | 80 · Assistant surgeon | $70.79 | $83.18 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $100.00 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $100.00 |
CDPHP Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,445.44 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,230.27 | Professional | None | $537.03 | $537.03 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $2,290.87 | Facility | None | $630.96 | $831.76 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Professional | None | $501.19 | $660.69 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $724.44 | Professional | None | $309.03 | $524.81 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $575.44 Median $3,235.94 Typical High $4,365.16 | Facility | None | $575.44 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,230.27 | Professional | None | $562.34 | $691.83 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,318.26 | Professional | None | $398.11 | $562.34 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $2,137.96 | Facility | None | $363.08 | $501.19 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Professional | None | $363.08 | $501.19 | $724.44 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $416.87 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $398.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $416.87 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $416.87 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $109.65 Typical High $151.36 | Professional | 55 · Aftercare only | $64.57 | $109.65 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $30.90 | $52.48 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $426.58 | Professional | 53 · Discontinued | $281.84 | $288.40 | $426.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $416.87 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $416.87 | $562.34 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $109.65 Typical High $295.12 | Professional | 55 · Aftercare only | $64.57 | $109.65 | $295.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $52.48 Typical High $141.25 | Professional | 56 · Pre-op care only | $30.90 | $52.48 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $501.19 |
Where New York sits
The same service costs 4.8 times more in Connecticut than in Kansas. 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
CT $8,034KS $1,664
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.