How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $12,023Professionalmedian $724 · 10th to 90th $589 to $1,202
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 $1,737.80 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,737.80 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | None | $758.58 | $758.58 | $776.25 |
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 $602.56 Median $707.95 Typical High $977.24 | Professional | None | $602.56 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,071.52 Typical High $1,445.44 | Professional | 50 · Both sides | $912.01 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $446.68 Typical High $616.60 | Professional | 62 · Two surgeons | $380.19 | $446.68 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $134.90 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $134.90 |
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 $1,445.44 Median $10,964.78 Typical High $22,387.21 | Facility | None | $1,445.44 | $10,964.78 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,698.24 | Professional | None | $724.44 | $724.44 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $3,019.95 | Facility | None | $794.33 | $954.99 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,318.26 | Professional | None | $676.08 | $851.14 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,000.00 | Professional | None | $436.52 | $676.08 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $741.31 Median $4,786.30 Typical High $5,754.40 | Facility | None | $741.31 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,862.09 | Professional | None | $776.25 | $1,047.13 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,778.28 | Professional | None | $512.86 | $758.58 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $3,019.95 | Facility | None | $512.86 | $676.08 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,000.00 | Professional | None | $512.86 | $676.08 | $1,000.00 |
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 $380.19 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $851.14 | Professional | 54 · Surgery only | $346.74 | $537.03 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $229.09 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $107.15 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $741.31 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $575.44 | Professional | 53 · Discontinued | $380.19 | $389.05 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $794.33 | Professional | 54 · Surgery only | $346.74 | $537.03 | $794.33 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $407.38 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $194.98 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $691.83 |
Where New York sits
The same service costs 7.4 times more in Alabama 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
AL $14,977KY $2,013
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.