How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,288 to $11,220Professionalmedian $794 · 10th to 90th $631 to $1,318
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $933.25 | Professional | None | $812.83 | $851.14 | $933.25 |
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 $660.69 Median $776.25 Typical High $1,096.48 | Professional | None | $660.69 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,148.15 Typical High $1,621.81 | Professional | 50 · Both sides | $977.24 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $691.83 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $173.78 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $151.36 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $151.36 |
CDPHP Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,445.44 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,819.70 | Professional | None | $812.83 | $812.83 | $1,819.70 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,122.02 Typical High $3,019.95 | Facility | None | $870.96 | $1,122.02 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,318.26 | Professional | None | $741.31 | $851.14 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,000.00 | Professional | None | $436.52 | $676.08 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $5,754.40 | Facility | None | $851.14 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,041.74 | Professional | None | $831.76 | $1,230.27 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $14,454.40 | Facility | None | $1,380.38 | $4,677.35 | $14,454.40 |
United Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,905.46 | Professional | None | $524.81 | $812.83 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $512.86 Median $741.31 Typical High $3,715.35 | Facility | None | $512.86 | $741.31 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,000.00 | Professional | None | $512.86 | $676.08 | $1,000.00 |
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 $407.38 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $588.84 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $851.14 | Professional | 54 · Surgery only | $346.74 | $537.03 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $141.25 Typical High $229.09 | Professional | 55 · Aftercare only | $91.20 | $141.25 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $107.15 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $741.31 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $602.56 | Professional | 53 · Discontinued | $416.87 | $416.87 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $794.33 | Professional | 54 · Surgery only | $346.74 | $537.03 | $794.33 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $141.25 Typical High $407.38 | Professional | 55 · Aftercare only | $91.20 | $141.25 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $194.98 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $741.31 |
Where New York sits
The same service costs 4.3 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 $9,769TX $2,271
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.