How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,698 to $14,454Professionalmedian $2,455 · 10th to 90th $1,950 to $4,169
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 $2,454.71 Median $6,309.57 Typical High $12,589.25 | Facility | None | $2,454.71 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $4,897.79 | Professional | None | $2,511.89 | $2,630.27 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,398.83 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $537.03 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $331.13 Typical High $467.74 | Professional | AS · PA/NP assist | $281.84 | $331.13 | $467.74 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,737.80 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $5,754.40 | Professional | None | $2,570.40 | $2,570.40 | $5,754.40 |
Emblem Health Setting Facility Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $9,120.11 | Facility | None | $2,691.53 | $3,548.13 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,290.87 | $2,754.23 | $4,365.16 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $4,073.80 | Professional | None | $1,148.15 | $2,137.96 | $4,073.80 |
MVP Health Care Setting Facility Modifier None Typical Low $2,398.83 Median $5,754.40 Typical High $38,018.94 | Facility | None | $2,398.83 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $5,370.32 | Professional | None | $2,570.40 | $3,090.30 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,791.08 | Facility | None | $1,318.26 | $4,168.69 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $6,025.60 | Professional | None | $1,659.59 | $2,570.40 | $6,025.60 |
Univera Setting Facility Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,348.96 | $2,290.87 | $7,079.46 |
Univera Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $4,073.80 | Professional | None | $1,348.96 | $2,137.96 | $4,073.80 |
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 $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,258.93 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,905.46 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,819.70 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,698.24 Typical High $3,235.94 | Professional | 54 · Surgery only | $912.01 | $1,698.24 | $3,235.94 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $446.68 Typical High $851.14 | Professional | 55 · Aftercare only | $239.88 | $446.68 | $851.14 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $213.80 Typical High $407.38 | Professional | 56 · Pre-op care only | $114.82 | $213.80 | $407.38 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,479.11 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $794.33 | $1,479.11 | $2,818.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,288.25 Median $1,288.25 Typical High $1,862.09 | Professional | 53 · Discontinued | $1,288.25 | $1,288.25 | $1,862.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,698.24 Typical High $3,235.94 | Professional | 54 · Surgery only | $912.01 | $1,698.24 | $3,235.94 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $446.68 Typical High $1,318.26 | Professional | 55 · Aftercare only | $239.88 | $446.68 | $1,318.26 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $213.80 Typical High $630.96 | Professional | 56 · Pre-op care only | $114.82 | $213.80 | $630.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,479.11 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $794.33 | $1,479.11 | $2,818.38 |
Where New York sits
The same service costs 4.0 times more in Alaska than in Texas. 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 $19,772TX $4,915
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.