How much rates vary
Facilitymedian $4,467 · 10th to 90th $708 to $12,589Professionalmedian $813 · 10th to 90th $676 to $1,349
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 $954.99 Median $4,365.16 Typical High $11,481.54 | Facility | None | $954.99 | $4,365.16 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $2,238.72 | Professional | None | $776.25 | $812.83 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | None | $645.65 | $645.65 | $660.69 |
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 $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $131.83 Typical High $204.17 | Professional | 80 · Assistant surgeon | $114.82 | $131.83 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $151.36 |
CDPHP Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $12,882.50 | Facility | None | $4,365.16 | $4,365.16 | $12,882.50 |
CDPHP Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $1,949.84 | Facility | None | $851.14 | $1,737.80 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $6,456.54 | Professional | None | $794.33 | $794.33 | $6,456.54 |
Emblem Health Setting Facility Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,818.38 | Facility | None | $812.83 | $1,174.90 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,318.26 | Professional | None | $707.95 | $794.33 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $346.74 Median $630.96 Typical High $1,230.27 | Professional | None | $346.74 | $630.96 | $1,230.27 |
Highmark BCBS Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $7,079.46 | Facility | None | $812.83 | $2,884.03 | $7,079.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,071.52 | Professional | None | $630.96 | $1,023.29 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $5,754.40 Typical High $38,018.94 | Facility | None | $831.76 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,995.26 | Professional | None | $794.33 | $1,122.02 | $1,995.26 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,949.84 | Professional | None | $501.19 | $776.25 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $707.95 Typical High $8,511.38 | Facility | None | $407.38 | $707.95 | $8,511.38 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,230.27 | Professional | None | $407.38 | $630.96 | $1,230.27 |
6 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 $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $575.44 | Professional | 53 · Discontinued | $398.11 | $398.11 | $575.44 |
Where New York sits
The same service costs 15.4 times more in Alabama than in Maryland. 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
AL $15,703MD $1,022
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.