How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $9,772Professionalmedian $617 · 10th to 90th $490 to $977
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 $5,370.32 Typical High $9,772.37 | Facility | None | $1,659.59 | $5,370.32 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $707.95 | Professional | None | $630.96 | $660.69 | $707.95 |
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 $524.81 Median $616.60 Typical High $812.83 | Professional | None | $524.81 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $1,230.27 | Professional | 50 · Both sides | $776.25 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $389.05 Typical High $512.86 | Professional | 62 · Two surgeons | $331.13 | $389.05 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $131.83 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $85.11 Typical High $125.89 | Professional | AS · PA/NP assist | $72.44 | $85.11 | $125.89 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,621.81 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,380.38 | Professional | None | $562.34 | $562.34 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $2,238.72 | Facility | None | $630.96 | $954.99 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $977.24 | Professional | None | $537.03 | $645.65 | $977.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $794.33 | Professional | None | $338.84 | $524.81 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $5,754.40 | Facility | None | $676.08 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,513.56 | Professional | None | $645.65 | $933.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,380.38 | Professional | None | $380.19 | $602.56 | $1,380.38 |
Univera Setting Facility Modifier None Typical Low $398.11 Median $537.03 Typical High $2,754.23 | Facility | None | $398.11 | $537.03 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | None | $398.11 | $524.81 | $794.33 |
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 $316.23 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $467.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $407.38 Typical High $660.69 | Professional | 54 · Surgery only | $269.15 | $407.38 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $109.65 Typical High $177.83 | Professional | 55 · Aftercare only | $70.79 | $109.65 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $52.48 Typical High $85.11 | Professional | 56 · Pre-op care only | $33.88 | $52.48 | $85.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $575.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $478.63 | Professional | 53 · Discontinued | $323.59 | $331.13 | $478.63 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $407.38 Typical High $616.60 | Professional | 54 · Surgery only | $269.15 | $407.38 | $616.60 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $109.65 Typical High $316.23 | Professional | 55 · Aftercare only | $70.79 | $109.65 | $316.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $52.48 Typical High $151.36 | Professional | 56 · Pre-op care only | $33.88 | $52.48 | $151.36 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $537.03 |
Where New York sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.