How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,349 to $9,550Professionalmedian $1,549 · 10th to 90th $1,259 to $2,570
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 $5,370.32 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,370.32 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,621.81 | $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 $1,288.25 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,290.87 Typical High $3,162.28 | Professional | 50 · Both sides | $1,949.84 | $2,290.87 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $338.84 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $295.12 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $295.12 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $4,265.80 | Facility | None | $1,548.82 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,548.82 | $1,548.82 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,698.24 Typical High $5,623.41 | Facility | None | $977.24 | $1,698.24 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,698.24 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,041.74 | Professional | None | $891.25 | $1,348.96 | $2,041.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Highmark BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Professional | None | $2,884.03 | $2,884.03 | $3,019.95 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,698.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,344.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,023.29 | $1,621.81 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $4,466.84 | Facility | None | $1,047.13 | $1,445.44 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,348.96 | $2,041.74 |
10 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 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,071.52 Typical High $1,737.80 | Professional | 54 · Surgery only | $691.83 | $1,071.52 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $457.09 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $457.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $134.90 Typical High $218.78 | Professional | 56 · Pre-op care only | $89.13 | $134.90 | $218.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $933.25 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $602.56 | $933.25 | $1,513.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,071.52 Typical High $1,621.81 | Professional | 54 · Surgery only | $691.83 | $1,071.52 | $1,621.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $831.76 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $831.76 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $134.90 Typical High $389.05 | Professional | 56 · Pre-op care only | $89.13 | $134.90 | $389.05 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $933.25 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $602.56 | $933.25 | $1,445.44 |
Where New York sits
The same service costs 3.4 times more in Alaska 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
AK $9,940MD $2,898
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.