How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,413 to $11,749Professionalmedian $1,479 · 10th to 90th $1,175 to $2,455
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 $1,905.46 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,905.46 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,187.76 Typical High $2,951.21 | Professional | 50 · Both sides | $1,862.09 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $794.33 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $275.42 |
CDPHP Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,479.11 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,479.11 | $3,467.37 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $5,370.32 | Facility | None | $1,023.29 | $1,621.81 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,621.81 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,949.84 | Professional | None | $851.14 | $1,288.25 | $1,949.84 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,019.95 | Professional | None | $1,230.27 | $1,230.27 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $3,630.78 | Professional | None | $912.01 | $1,548.82 | $3,630.78 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,380.38 | $4,265.80 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,949.84 | Professional | None | $851.14 | $1,288.25 | $1,949.84 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,023.29 Typical High $1,548.82 | Professional | 54 · Surgery only | $676.08 | $1,023.29 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $269.15 Typical High $416.87 | Professional | 55 · Aftercare only | $177.83 | $269.15 | $416.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $128.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $85.11 | $128.82 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $891.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $588.84 | $891.25 | $1,348.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,174.90 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,023.29 Typical High $1,548.82 | Professional | 54 · Surgery only | $676.08 | $1,023.29 | $1,548.82 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $269.15 Typical High $812.83 | Professional | 55 · Aftercare only | $177.83 | $269.15 | $812.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $128.82 Typical High $389.05 | Professional | 56 · Pre-op care only | $85.11 | $128.82 | $389.05 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $891.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $588.84 | $891.25 | $1,380.38 |
Where New York sits
The same service costs 5.5 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 $15,938KY $2,890
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.