How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,380 to $15,136Professionalmedian $1,000 · 10th to 90th $813 to $1,660
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 $5,754.40 Typical High $11,481.54 | Facility | None | $1,819.70 | $5,754.40 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,047.13 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,380.38 | Professional | None | $831.76 | $977.24 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $2,041.74 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $851.14 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $190.55 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $190.55 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $14,454.40 Typical High $29,512.09 | Facility | None | $1,621.81 | $14,454.40 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,000.00 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $3,630.78 | Facility | None | $1,000.00 | $1,202.26 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,737.80 | Professional | None | $933.25 | $1,122.02 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,348.96 | Professional | None | $575.44 | $891.25 | $1,348.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $5,754.40 Typical High $23,442.29 | Facility | None | $1,071.52 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,513.56 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,168.69 | $14,454.40 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $2,454.71 | Professional | None | $676.08 | $1,047.13 | $2,454.71 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $4,265.80 | Facility | None | $676.08 | $933.25 | $4,265.80 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,348.96 | Professional | None | $676.08 | $891.25 | $1,348.96 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $741.31 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $707.95 Typical High $1,122.02 | Professional | 54 · Surgery only | $457.09 | $707.95 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $186.21 Typical High $302.00 | Professional | 55 · Aftercare only | $120.23 | $186.21 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $89.13 Typical High $144.54 | Professional | 56 · Pre-op care only | $57.54 | $89.13 | $144.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $977.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $537.03 Typical High $794.33 | Professional | 53 · Discontinued | $524.81 | $537.03 | $794.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $707.95 Typical High $1,047.13 | Professional | 54 · Surgery only | $457.09 | $707.95 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $186.21 Typical High $537.03 | Professional | 55 · Aftercare only | $120.23 | $186.21 | $537.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $89.13 Typical High $257.04 | Professional | 56 · Pre-op care only | $57.54 | $89.13 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $933.25 |
Where New York sits
The same service costs 7.2 times more in Alaska than in Hawaii. 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 $19,657HI $2,734
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.