How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,514 to $11,220Professionalmedian $1,622 · 10th to 90th $1,318 to $2,754
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,698.24 | $3,235.94 |
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 $1,380.38 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,398.83 Typical High $3,311.31 | Professional | 50 · Both sides | $2,041.74 | $2,398.83 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,023.29 Typical High $1,412.54 | Professional | 62 · Two surgeons | $851.14 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $309.03 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $309.03 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $15,848.93 | Facility | None | $1,737.80 | $7,943.28 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,621.81 | $1,621.81 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $5,754.40 | Facility | None | $1,778.28 | $2,454.71 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,778.28 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,137.96 | Professional | None | $933.25 | $1,412.54 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,737.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,290.87 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,071.52 | $1,698.24 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $6,606.93 | Facility | None | $1,096.48 | $1,513.56 | $6,606.93 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,412.54 | $2,137.96 |
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 $851.14 Median $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,698.24 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $457.09 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $457.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $213.80 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $870.96 Typical High $1,288.25 | Professional | 53 · Discontinued | $870.96 | $870.96 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,698.24 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,698.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $891.25 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $891.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $426.58 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $1,513.56 |
Where New York sits
The same service costs 4.7 times more in Alaska 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
AK $16,761KY $3,604
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.