How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,965Professionalmedian $813 · 10th to 90th $661 to $1,349
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 $5,754.40 Typical High $11,748.98 | Facility | None | $1,819.70 | $5,754.40 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | None | $851.14 | $851.14 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $11,220.18 | Facility | None | $1,513.56 | $4,466.84 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,096.48 | Professional | None | $676.08 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,659.59 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $691.83 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $154.88 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $154.88 |
CDPHP Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $6,165.95 Typical High $12,589.25 | Facility | None | $1,445.44 | $6,165.95 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,862.09 | Professional | None | $812.83 | $812.83 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $3,019.95 | Facility | None | $416.87 | $933.25 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,412.54 | Professional | None | $758.58 | $776.25 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,096.48 | Professional | None | $467.74 | $741.31 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $870.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,137.96 | Professional | None | $870.96 | $1,202.26 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $2,041.74 | Professional | None | $549.54 | $851.14 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $3,235.94 | Facility | None | $549.54 | $758.58 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,096.48 | Professional | None | $549.54 | $741.31 | $1,096.48 |
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 $436.52 | Professional | 52 · Reduced service | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $575.44 Typical High $933.25 | Professional | 54 · Surgery only | $371.54 | $575.44 | $933.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $154.88 Typical High $245.47 | Professional | 55 · Aftercare only | $100.00 | $154.88 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $74.13 Typical High $117.49 | Professional | 56 · Pre-op care only | $46.77 | $74.13 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $812.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $446.68 Typical High $645.65 | Professional | 53 · Discontinued | $436.52 | $446.68 | $645.65 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $575.44 Typical High $870.96 | Professional | 54 · Surgery only | $371.54 | $575.44 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $154.88 Typical High $436.52 | Professional | 55 · Aftercare only | $100.00 | $154.88 | $436.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $74.13 Typical High $208.93 | Professional | 56 · Pre-op care only | $46.77 | $74.13 | $208.93 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $758.58 |
Where New York sits
The same service costs 6.3 times more in Alaska than in Texas. 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 $11,332TX $1,794
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.