How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,585 to $26,303Professionalmedian $1,698 · 10th to 90th $1,380 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 $1,819.70 Median $7,079.46 Typical High $26,915.35 | Facility | None | $1,819.70 | $7,079.46 | $26,915.35 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $5,623.41 | Professional | None | $1,621.81 | $1,698.24 | $5,623.41 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,412.54 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $9,332.54 Typical High $24,547.09 | Facility | None | $1,778.28 | $9,332.54 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,737.80 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,096.48 Typical High $1,380.38 | Professional | 62 · Two surgeons | $933.25 | $1,096.48 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $245.47 Typical High $309.03 | Professional | AS · PA/NP assist | $208.93 | $245.47 | $309.03 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $21,877.62 Typical High $43,651.58 | Facility | None | $1,737.80 | $21,877.62 | $43,651.58 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $7,079.46 | Professional | None | $1,621.81 | $1,621.81 | $7,079.46 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $6,165.95 | Facility | None | $1,737.80 | $2,290.87 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,715.35 | Professional | None | $1,479.11 | $1,737.80 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,380.38 Typical High $2,630.27 | Professional | None | $741.31 | $1,380.38 | $2,630.27 |
Highmark BCBS Setting Facility Modifier None Typical Low $812.83 Median $7,943.28 Typical High $30,902.95 | Facility | None | $812.83 | $7,943.28 | $30,902.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,884.03 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,621.81 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,089.30 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,365.16 Typical High $23,988.33 | Facility | None | $1,318.26 | $4,365.16 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $4,073.80 | Professional | None | $1,071.52 | $1,659.59 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,479.11 Typical High $6,918.31 | Facility | None | $870.96 | $1,479.11 | $6,918.31 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,630.27 | Professional | None | $870.96 | $1,380.38 | $2,630.27 |
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 $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,096.48 Typical High $2,089.30 | Professional | 54 · Surgery only | $588.84 | $1,096.48 | $2,089.30 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $288.40 Typical High $549.54 | Professional | 55 · Aftercare only | $154.88 | $288.40 | $549.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $138.04 Typical High $263.03 | Professional | 56 · Pre-op care only | $74.13 | $138.04 | $263.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $954.99 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $512.86 | $954.99 | $1,819.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | 53 · Discontinued | $831.76 | $831.76 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,096.48 Typical High $2,089.30 | Professional | 54 · Surgery only | $588.84 | $1,096.48 | $2,089.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $288.40 Typical High $831.76 | Professional | 55 · Aftercare only | $154.88 | $288.40 | $831.76 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $138.04 Typical High $398.11 | Professional | 56 · Pre-op care only | $74.13 | $138.04 | $398.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $954.99 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $512.86 | $954.99 | $1,819.70 |
Where New York sits
The same service costs 6.9 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 $23,835KY $3,447
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.