How much rates vary
Facilitymedian $3,311 · 10th to 90th $912 to $7,943Professionalmedian $490 · 10th to 90th $347 to $813
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 $537.03 Median $5,128.61 Typical High $10,964.78 | Facility | None | $537.03 | $5,128.61 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $549.54 | Professional | None | $354.81 | $524.81 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $691.83 | Professional | None | $416.87 | $489.78 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $741.31 Typical High $1,000.00 | Professional | 50 · Both sides | $630.96 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $309.03 Typical High $416.87 | Professional | 62 · Two surgeons | $263.03 | $309.03 | $416.87 |
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 $501.19 Median $501.19 Typical High $758.58 | Professional | None | $501.19 | $501.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $3,235.94 | Facility | None | $1,122.02 | $1,905.46 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,122.02 | Professional | None | $331.13 | $489.78 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $1,412.54 | Facility | None | $398.11 | $630.96 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,000.00 | Professional | None | $467.74 | $645.65 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $741.31 | Professional | None | $302.00 | $524.81 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $19,952.62 | Facility | None | $1,819.70 | $2,511.89 | $19,952.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $954.99 | Professional | None | $489.78 | $512.86 | $954.99 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $4,365.16 Typical High $36,307.81 | Facility | None | $389.05 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,318.26 | Professional | None | $549.54 | $707.95 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $933.25 | Professional | None | $295.12 | $467.74 | $933.25 |
Univera Setting Facility Modifier None Typical Low $245.47 Median $467.74 Typical High $1,584.89 | Facility | None | $245.47 | $467.74 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $691.83 | Professional | None | $354.81 | $467.74 | $691.83 |
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 $177.83 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $269.15 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $35.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $407.38 Typical High $588.84 | Professional | 54 · Surgery only | $234.42 | $407.38 | $588.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $109.65 Typical High $154.88 | Professional | 55 · Aftercare only | $63.10 | $109.65 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $52.48 Typical High $74.13 | Professional | 56 · Pre-op care only | $30.20 | $52.48 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $208.93 | $354.81 | $512.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $407.38 | Professional | 53 · Discontinued | $275.42 | $281.84 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $234.42 | $407.38 | $549.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $109.65 Typical High $263.03 | Professional | 55 · Aftercare only | $63.10 | $109.65 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $52.48 Typical High $125.89 | Professional | 56 · Pre-op care only | $30.20 | $52.48 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $363.08 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $208.93 | $363.08 | $478.63 |
Where New York sits
The same service costs 3.9 times more in Alabama than in Montana. 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 $5,160MT $1,330
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.