How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,230 to $10,233Professionalmedian $832 · 10th to 90th $676 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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,621.81 | Professional | None | $831.76 | $831.76 | $1,621.81 |
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 $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,621.81 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $676.08 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $173.78 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $151.36 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,348.96 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,862.09 | Professional | None | $794.33 | $794.33 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $3,162.28 | Facility | None | $831.76 | $1,071.52 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,380.38 | Professional | None | $741.31 | $912.01 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,071.52 | Professional | None | $457.09 | $724.44 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $812.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $2,041.74 | Professional | None | $851.14 | $977.24 | $2,041.74 |
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 $549.54 Median $831.76 Typical High $1,949.84 | Professional | None | $549.54 | $831.76 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $3,630.78 | Facility | None | $537.03 | $741.31 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,071.52 | Professional | None | $537.03 | $724.44 | $1,071.52 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $575.44 Typical High $912.01 | Professional | 54 · Surgery only | $363.08 | $575.44 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $151.36 Typical High $239.88 | Professional | 55 · Aftercare only | $97.72 | $151.36 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $72.44 Typical High $114.82 | Professional | 56 · Pre-op care only | $45.71 | $72.44 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $501.19 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $316.23 | $501.19 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $630.96 | Professional | 53 · Discontinued | $416.87 | $426.58 | $630.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $575.44 Typical High $851.14 | Professional | 54 · Surgery only | $363.08 | $575.44 | $851.14 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $151.36 Typical High $426.58 | Professional | 55 · Aftercare only | $97.72 | $151.36 | $426.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $72.44 Typical High $204.17 | Professional | 56 · Pre-op care only | $45.71 | $72.44 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $501.19 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $316.23 | $501.19 | $741.31 |
Where New York sits
The same service costs 3.1 times more in Wisconsin 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
WI $8,115MD $2,591
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.