How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,660 to $16,218Professionalmedian $1,660 · 10th to 90th $1,318 to $2,951
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 $2,137.96 Median $6,309.57 Typical High $12,882.50 | Facility | None | $2,137.96 | $6,309.57 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,137.96 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,819.70 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,621.81 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $1,513.56 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $380.19 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $229.09 Typical High $331.13 | Professional | AS · PA/NP assist | $194.98 | $229.09 | $331.13 |
CDPHP Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $19,952.62 Typical High $41,686.94 | Facility | None | $1,737.80 | $19,952.62 | $41,686.94 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $4,073.80 | Professional | None | $1,737.80 | $1,737.80 | $4,073.80 |
Emblem Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $6,165.95 | Facility | None | $1,862.09 | $2,511.89 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,862.09 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $2,951.21 | Professional | None | $831.76 | $1,479.11 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $1,819.70 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,819.70 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,801.89 | Professional | None | $1,513.56 | $1,513.56 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $16,982.44 | Facility | None | $1,380.38 | $4,786.30 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,819.70 | $4,168.69 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,621.81 Typical High $4,677.35 | Facility | None | $977.24 | $1,621.81 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,951.21 | Professional | None | $977.24 | $1,479.11 | $2,951.21 |
10 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 54 · Surgery only Typical Low $1,380.38 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,380.38 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,513.56 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,174.90 Typical High $2,290.87 | Professional | 54 · Surgery only | $645.65 | $1,174.90 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $309.03 Typical High $616.60 | Professional | 55 · Aftercare only | $173.78 | $309.03 | $616.60 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $147.91 Typical High $295.12 | Professional | 56 · Pre-op care only | $83.18 | $147.91 | $295.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,023.29 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $575.44 | $1,023.29 | $2,041.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,174.90 Typical High $2,290.87 | Professional | 54 · Surgery only | $645.65 | $1,174.90 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $309.03 Typical High $954.99 | Professional | 55 · Aftercare only | $173.78 | $309.03 | $954.99 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $147.91 Typical High $446.68 | Professional | 56 · Pre-op care only | $83.18 | $147.91 | $446.68 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,023.29 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $575.44 | $1,023.29 | $2,041.74 |
Where New York sits
The same service costs 6.7 times more in Wyoming 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
WY $23,934KY $3,572
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.