How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $9,550Professionalmedian $302 · 10th to 90th $191 to $490
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 $1,659.59 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,659.59 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $331.13 | Professional | None | $181.97 | $288.40 | $331.13 |
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 $269.15 Median $316.23 Typical High $426.58 | Professional | None | $269.15 | $316.23 | $426.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $169.82 Median $199.53 Typical High $263.03 | Professional | 62 · Two surgeons | $169.82 | $199.53 | $263.03 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $446.68 | Professional | None | $281.84 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $741.31 | Professional | None | $190.55 | $302.00 | $741.31 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $912.01 | Facility | None | $234.42 | $281.84 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $691.83 | Professional | None | $288.40 | $467.74 | $691.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $467.74 | Professional | None | $199.53 | $346.74 | $467.74 |
MVP Health Care Setting Facility Modifier None Typical Low $223.87 Median $3,235.94 Typical High $4,365.16 | Facility | None | $223.87 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $794.33 | Professional | None | $302.00 | $302.00 | $794.33 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $562.34 | Professional | None | $165.96 | $275.42 | $562.34 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $288.40 Typical High $1,071.52 | Facility | None | $151.36 | $288.40 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $467.74 | Professional | None | $234.42 | $316.23 | $467.74 |
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 $91.20 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $91.20 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $36.31 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $125.89 | $199.53 | $229.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $309.03 Typical High $446.68 | Professional | 54 · Surgery only | $181.97 | $309.03 | $446.68 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $34.67 Typical High $50.12 | Professional | 55 · Aftercare only | $19.95 | $34.67 | $50.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $34.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $19.95 | $34.67 | $50.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $275.42 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $158.49 | $275.42 | $398.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $245.47 | Professional | 53 · Discontinued | $162.18 | $165.96 | $245.47 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $181.97 | $309.03 | $416.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $37.15 Typical High $75.86 | Professional | 55 · Aftercare only | $19.95 | $37.15 | $75.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $37.15 Typical High $75.86 | Professional | 56 · Pre-op care only | $19.95 | $37.15 | $75.86 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $288.40 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $158.49 | $288.40 | $371.54 |
Where New York sits
The same service costs 10.2 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 $8,109MT $791
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.