How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,514 to $19,498Professionalmedian $1,202 · 10th to 90th $955 to $1,995
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,288.25 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,548.82 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $234.42 |
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $21,379.62 Typical High $43,651.58 | Facility | None | $1,513.56 | $21,379.62 | $43,651.58 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,258.93 | $1,995.26 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,318.26 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $691.83 | $1,047.13 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,584.89 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,791.08 | Facility | None | $1,318.26 | $4,073.80 | $14,791.08 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,884.03 | Professional | None | $776.25 | $1,230.27 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $4,786.30 | Facility | None | $812.83 | $1,122.02 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
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 $630.96 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $630.96 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $1,288.25 | Professional | 54 · Surgery only | $549.54 | $831.76 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $338.84 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $338.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $104.71 Typical High $162.18 | Professional | 56 · Pre-op care only | $69.18 | $104.71 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $478.63 | $724.44 | $1,122.02 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $660.69 Typical High $954.99 | Professional | 53 · Discontinued | $645.65 | $660.69 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $1,258.93 | Professional | 54 · Surgery only | $549.54 | $831.76 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $645.65 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $645.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $104.71 Typical High $309.03 | Professional | 56 · Pre-op care only | $69.18 | $104.71 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $478.63 | $724.44 | $1,122.02 |
Where New York sits
The same service costs 9.2 times more in Alaska than in Hawaii. 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 $30,716HI $3,333
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.