How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,259 to $10,715Professionalmedian $832 · 10th to 90th $676 to $1,413
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 $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
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 $707.95 Median $831.76 Typical High $1,174.90 | Professional | None | $707.95 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,737.80 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $524.81 Typical High $776.25 | Professional | 62 · Two surgeons | $446.68 | $524.81 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $162.18 |
CDPHP Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $870.96 Median $870.96 Typical High $1,949.84 | Professional | None | $870.96 | $870.96 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $912.01 Median $1,202.26 Typical High $3,162.28 | Facility | None | $912.01 | $1,202.26 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,412.54 | Professional | None | $794.33 | $912.01 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,071.52 | Professional | None | $467.74 | $724.44 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $933.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $933.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,187.76 | Professional | None | $891.25 | $1,380.38 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $2,089.30 | Professional | None | $549.54 | $891.25 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $549.54 Median $794.33 Typical High $3,890.45 | Facility | None | $549.54 | $794.33 | $3,890.45 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | None | $549.54 | $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 $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $562.34 Typical High $912.01 | Professional | 54 · Surgery only | $363.08 | $562.34 | $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 $46.77 Median $72.44 Typical High $114.82 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $489.78 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $316.23 | $489.78 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $457.09 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $562.34 Typical High $851.14 | Professional | 54 · Surgery only | $363.08 | $562.34 | $851.14 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $151.36 Typical High $436.52 | Professional | 55 · Aftercare only | $97.72 | $151.36 | $436.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $72.44 Typical High $204.17 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $489.78 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $316.23 | $489.78 | $794.33 |
Where New York sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.