How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $9,772Professionalmedian $851 · 10th to 90th $692 to $1,514
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 $870.96 Median $870.96 Typical High $1,819.70 | Professional | None | $870.96 | $870.96 | $1,819.70 |
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 $691.83 Median $812.83 Typical High $1,202.26 | Professional | None | $691.83 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $758.58 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $190.55 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $169.82 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $169.82 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,548.82 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,041.74 | Professional | None | $933.25 | $933.25 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $3,548.13 | Facility | None | $977.24 | $1,258.93 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,621.81 | Professional | None | $870.96 | $1,071.52 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,202.26 | Professional | None | $524.81 | $851.14 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $933.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $933.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,290.87 | Professional | None | $933.25 | $1,122.02 | $2,290.87 |
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 $645.65 Median $933.25 Typical High $2,238.72 | Professional | None | $645.65 | $933.25 | $2,238.72 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $870.96 Typical High $4,570.88 | Facility | None | $616.60 | $870.96 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,202.26 | Professional | None | $616.60 | $851.14 | $1,202.26 |
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 $489.78 | Professional | 52 · Reduced service | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $676.08 Typical High $954.99 | Professional | 54 · Surgery only | $416.87 | $676.08 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $177.83 Typical High $257.04 | Professional | 55 · Aftercare only | $109.65 | $177.83 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $85.11 Typical High $123.03 | Professional | 56 · Pre-op care only | $52.48 | $85.11 | $123.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $588.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $363.08 | $588.84 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $691.83 | Professional | 53 · Discontinued | $467.74 | $478.63 | $691.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $676.08 Typical High $954.99 | Professional | 54 · Surgery only | $416.87 | $676.08 | $954.99 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $177.83 Typical High $489.78 | Professional | 55 · Aftercare only | $109.65 | $177.83 | $489.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $85.11 Typical High $234.42 | Professional | 56 · Pre-op care only | $52.48 | $85.11 | $234.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $588.84 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $363.08 | $588.84 | $870.96 |
Where New York sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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 $8,167HI $2,648
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.