How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,259 to $11,482Professionalmedian $724 · 10th to 90th $589 to $1,622
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,187.76 | Professional | None | $812.83 | $812.83 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,479.11 | Professional | None | $602.56 | $707.95 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $446.68 Typical High $933.25 | Professional | 62 · Two surgeons | $380.19 | $446.68 | $933.25 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,318.26 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $2,951.21 | Professional | None | $616.60 | $851.14 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $2,818.38 | Facility | None | $562.34 | $891.25 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,479.11 | Professional | None | $831.76 | $912.01 | $1,479.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | None | $537.03 | $691.83 | $954.99 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $5,754.40 | Facility | None | $831.76 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,949.84 | Professional | None | $954.99 | $954.99 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $2,187.76 | Professional | None | $575.44 | $812.83 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $2,630.27 | Facility | None | $575.44 | $741.31 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $912.01 | Professional | None | $537.03 | $691.83 | $912.01 |
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 $407.38 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $912.01 | Professional | 54 · Surgery only | $457.09 | $588.84 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $95.50 Typical High $151.36 | Professional | 55 · Aftercare only | $74.13 | $95.50 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $107.15 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $812.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $524.81 Typical High $812.83 | Professional | 53 · Discontinued | $398.11 | $524.81 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $831.76 | Professional | 54 · Surgery only | $457.09 | $588.84 | $831.76 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $95.50 Typical High $218.78 | Professional | 55 · Aftercare only | $74.13 | $95.50 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $154.88 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $154.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $741.31 |
Where New York sits
The same service costs 4.2 times more in Alaska 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
AK $10,315MT $2,461
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.