How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,318 to $14,125Professionalmedian $813 · 10th to 90th $646 to $1,413
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | None | $851.14 | $851.14 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,148.15 | Professional | None | $645.65 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $724.44 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $177.83 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $162.18 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $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 $1,445.44 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,445.44 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,949.84 | Professional | None | $870.96 | $870.96 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $3,311.31 | Facility | None | $630.96 | $1,047.13 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,548.82 | Professional | None | $812.83 | $1,023.29 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,148.15 | Professional | None | $489.78 | $812.83 | $1,148.15 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,137.96 | Professional | None | $891.25 | $1,047.13 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $2,089.30 | Professional | None | $616.60 | $870.96 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $3,388.44 | Facility | None | $588.84 | $812.83 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
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 $426.58 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $645.65 Typical High $912.01 | Professional | 54 · Surgery only | $389.05 | $645.65 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $169.82 Typical High $239.88 | Professional | 55 · Aftercare only | $104.71 | $169.82 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $81.28 Typical High $114.82 | Professional | 56 · Pre-op care only | $48.98 | $81.28 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $562.34 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $338.84 | $562.34 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $446.68 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $645.65 Typical High $912.01 | Professional | 54 · Surgery only | $389.05 | $645.65 | $912.01 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $169.82 Typical High $478.63 | Professional | 55 · Aftercare only | $104.71 | $169.82 | $478.63 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $81.28 Typical High $223.87 | Professional | 56 · Pre-op care only | $48.98 | $81.28 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $562.34 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $338.84 | $562.34 | $812.83 |
Where New York sits
The same service costs 4.5 times more in Alaska than in Montana. 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 $12,963MT $2,892
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.