How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,585 to $26,303Professionalmedian $1,585 · 10th to 90th $1,288 to $2,692
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 $1,862.09 Median $6,918.31 Typical High $29,512.09 | Facility | None | $1,862.09 | $6,918.31 | $29,512.09 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,621.81 | $1,698.24 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $21,379.62 | Facility | None | $1,659.59 | $7,943.28 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,380.38 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $354.81 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $309.03 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $32,359.37 Typical High $50,118.72 | Facility | None | $1,737.80 | $32,359.37 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $6,606.93 | Professional | None | $1,659.59 | $1,659.59 | $6,606.93 |
Emblem Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,698.24 | $2,344.23 | $6,309.57 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,819.70 | $3,162.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $2,630.27 | Professional | None | $741.31 | $1,412.54 | $2,630.27 |
Highmark BCBS Setting Facility Modifier None Typical Low $33,113.11 Median $35,481.34 Typical High $35,481.34 | Facility | None | $33,113.11 | $35,481.34 | $35,481.34 |
MVP Health Care Setting Facility Modifier None Typical Low $1,584.89 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,584.89 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,137.96 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $25,703.96 | Facility | None | $1,380.38 | $4,786.30 | $25,703.96 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,096.48 | $1,698.24 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,513.56 Typical High $7,244.36 | Facility | None | $870.96 | $1,513.56 | $7,244.36 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $2,630.27 | Professional | None | $870.96 | $1,412.54 | $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 $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $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 $575.44 Median $1,122.02 Typical High $2,041.74 | Professional | 54 · Surgery only | $575.44 | $1,122.02 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $295.12 Typical High $549.54 | Professional | 55 · Aftercare only | $154.88 | $295.12 | $549.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $141.25 Typical High $263.03 | Professional | 56 · Pre-op care only | $74.13 | $141.25 | $263.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $977.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $501.19 | $977.24 | $1,778.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $1,230.27 | Professional | 53 · Discontinued | $831.76 | $831.76 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,122.02 Typical High $2,041.74 | Professional | 54 · Surgery only | $575.44 | $1,122.02 | $2,041.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $295.12 Typical High $812.83 | Professional | 55 · Aftercare only | $154.88 | $295.12 | $812.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $141.25 Typical High $389.05 | Professional | 56 · Pre-op care only | $74.13 | $141.25 | $389.05 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $977.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $501.19 | $977.24 | $1,778.28 |
Where New York sits
The same service costs 10.9 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 $39,570KY $3,638
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.