How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,230 to $9,550Professionalmedian $1,047 · 10th to 90th $851 to $1,738
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | None | $1,071.52 | $1,071.52 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $870.96 Median $1,023.29 Typical High $1,412.54 | Professional | None | $870.96 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $234.42 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $194.98 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $194.98 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $4,265.80 | Facility | None | $1,548.82 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,047.13 | $2,398.83 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $3,801.89 | Facility | None | $660.69 | $1,174.90 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,819.70 | Professional | None | $977.24 | $1,148.15 | $1,819.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,380.38 | Professional | None | $602.56 | $933.25 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,148.15 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,148.15 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,258.93 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $7,413.10 | Facility | None | $1,148.15 | $2,511.89 | $7,413.10 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $2,570.40 | Professional | None | $691.83 | $1,071.52 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $977.24 Typical High $3,019.95 | Facility | None | $707.95 | $977.24 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | None | $707.95 | $933.25 | $1,380.38 |
11 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 $812.83 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $812.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $478.63 | $724.44 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $309.03 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $309.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $147.91 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $147.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $1,023.29 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | 59 · Distinct service | $1,737.80 | $1,737.80 | $1,737.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $478.63 | $724.44 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $562.34 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $562.34 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $269.15 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $977.24 |
Where New York sits
The same service costs 3.6 times more in Wisconsin 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
WI $8,126KY $2,271
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.