How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $10,233Professionalmedian $871 · 10th to 90th $708 to $1,479
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | None | $891.25 | $891.25 | $977.24 |
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 $724.44 Median $851.14 Typical High $1,174.90 | Professional | None | $724.44 | $851.14 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $162.18 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $162.18 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,479.11 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,041.74 | Professional | None | $870.96 | $870.96 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,096.48 Typical High $3,548.13 | Facility | None | $870.96 | $1,096.48 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,548.82 | Professional | None | $831.76 | $870.96 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,174.90 | Professional | None | $512.86 | $812.83 | $1,174.90 |
MVP Health Care Setting Facility Modifier None Typical Low $954.99 Median $4,786.30 Typical High $5,754.40 | Facility | None | $954.99 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,238.72 | Professional | None | $933.25 | $933.25 | $2,238.72 |
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 $616.60 Median $912.01 Typical High $2,187.76 | Professional | None | $616.60 | $912.01 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $3,548.13 | Facility | None | $602.56 | $831.76 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,174.90 | Professional | None | $602.56 | $812.83 | $1,174.90 |
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 $436.52 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $645.65 Typical High $933.25 | Professional | 54 · Surgery only | $398.11 | $645.65 | $933.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $169.82 Typical High $245.47 | Professional | 55 · Aftercare only | $107.15 | $169.82 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $81.28 Typical High $117.49 | Professional | 56 · Pre-op care only | $51.29 | $81.28 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $562.34 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $354.81 | $562.34 | $812.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $691.83 | Professional | 53 · Discontinued | $457.09 | $467.74 | $691.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $645.65 Typical High $933.25 | Professional | 54 · Surgery only | $398.11 | $645.65 | $933.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $169.82 Typical High $489.78 | Professional | 55 · Aftercare only | $107.15 | $169.82 | $489.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $81.28 Typical High $234.42 | Professional | 56 · Pre-op care only | $51.29 | $81.28 | $234.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $354.81 | $562.34 | $831.76 |
Where New York sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.