How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,318 to $10,000Professionalmedian $1,175 · 10th to 90th $933 to $1,950
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 $5,248.07 Typical High $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,318.26 | $1,318.26 |
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 $1,000.00 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,174.90 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,238.72 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $933.25 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $933.25 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,412.54 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,230.27 | $2,691.53 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $4,466.84 | Facility | None | $512.86 | $1,380.38 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,380.38 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,096.48 Typical High $1,659.59 | Professional | None | $537.03 | $1,096.48 | $1,659.59 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $630.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,454.71 | Professional | None | $741.31 | $741.31 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,258.93 Typical High $2,884.03 | Professional | None | $724.44 | $1,258.93 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,951.21 | Facility | None | $831.76 | $1,148.15 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,659.59 | Professional | None | $707.95 | $1,096.48 | $1,659.59 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $851.14 Typical High $1,288.25 | Professional | 54 · Surgery only | $562.34 | $851.14 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $229.09 Typical High $346.74 | Professional | 55 · Aftercare only | $147.91 | $229.09 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $165.96 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $676.08 Typical High $977.24 | Professional | 53 · Discontinued | $660.69 | $676.08 | $977.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $851.14 Typical High $1,288.25 | Professional | 54 · Surgery only | $562.34 | $851.14 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $229.09 Typical High $676.08 | Professional | 55 · Aftercare only | $147.91 | $229.09 | $676.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $323.59 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $323.59 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $1,148.15 |
Where New York sits
The same service costs 3.7 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 $9,494KY $2,537
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.