How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,479 to $17,378Professionalmedian $1,072 · 10th to 90th $851 to $1,862
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 $2,238.72 Median $6,456.54 Typical High $12,882.50 | Facility | None | $2,238.72 | $6,456.54 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $3,467.37 | Professional | None | $1,148.15 | $1,148.15 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $16,218.10 | Facility | None | $1,778.28 | $8,511.38 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,479.11 | Professional | None | $912.01 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,238.72 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $234.42 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $22,387.21 Typical High $45,708.82 | Facility | None | $1,737.80 | $22,387.21 | $45,708.82 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,071.52 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $3,981.07 | Facility | None | $1,202.26 | $1,621.81 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,202.26 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,479.11 | Professional | None | $630.96 | $977.24 | $1,479.11 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,584.89 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,659.59 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,265.80 Typical High $14,791.08 | Facility | None | $1,318.26 | $4,265.80 | $14,791.08 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $2,691.53 | Professional | None | $724.44 | $1,122.02 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $831.76 Typical High $4,677.35 | Facility | None | $741.31 | $831.76 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,445.44 | Professional | None | $741.31 | $933.25 | $1,445.44 |
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 $575.44 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $831.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $758.58 Typical High $1,230.27 | Professional | 54 · Surgery only | $501.19 | $758.58 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $204.17 Typical High $331.13 | Professional | 55 · Aftercare only | $131.83 | $204.17 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $154.88 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $660.69 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $436.52 | $660.69 | $1,071.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $870.96 | Professional | 53 · Discontinued | $575.44 | $588.84 | $870.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $758.58 Typical High $1,148.15 | Professional | 54 · Surgery only | $501.19 | $758.58 | $1,148.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $204.17 Typical High $588.84 | Professional | 55 · Aftercare only | $131.83 | $204.17 | $588.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $281.84 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $660.69 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $436.52 | $660.69 | $1,000.00 |
Where New York sits
The same service costs 9.3 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 $26,344KY $2,834
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.