How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,202 to $8,128Professionalmedian $1,230 · 10th to 90th $977 to $2,570
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 $11,748.98 | Facility | None | $1,819.70 | $5,888.44 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $3,890.45 | Professional | None | $1,380.38 | $1,380.38 | $3,890.45 |
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 $1,023.29 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,230.27 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,445.44 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $371.54 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $323.59 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $323.59 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $4,677.35 | Professional | None | $954.99 | $1,318.26 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $4,365.16 | Facility | None | $758.58 | $1,318.26 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,380.38 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,584.89 | Professional | None | $831.76 | $1,071.52 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,513.56 | $3,162.28 |
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 $933.25 Median $1,318.26 Typical High $3,467.37 | Professional | None | $933.25 | $1,318.26 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,884.03 | Facility | None | $912.01 | $1,148.15 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,548.82 | Professional | None | $831.76 | $1,071.52 | $1,548.82 |
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 $691.83 Median $691.83 Typical High $758.58 | Professional | 52 · Reduced service | $691.83 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $933.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $724.44 | $933.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $234.42 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $107.15 Typical High $169.82 | Professional | 56 · Pre-op care only | $83.18 | $107.15 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $812.83 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $645.65 | $812.83 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Professional | 53 · Discontinued | $645.65 | $851.14 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $933.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $724.44 | $933.25 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $338.84 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $107.15 Typical High $245.47 | Professional | 56 · Pre-op care only | $83.18 | $107.15 | $245.47 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $645.65 | $812.83 | $1,202.26 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $8,931DE $2,772
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.