How much rates vary
Facilitymedian $3,548 · 10th to 90th $708 to $10,233Professionalmedian $4,677 · 10th to 90th $3,715 to $9,333
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $9,772.37 | Professional | None | $5,370.32 | $5,370.32 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $9,120.11 | Professional | None | $3,981.07 | $4,677.35 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,511.89 Median $2,951.21 Typical High $5,754.40 | Professional | 62 · Two surgeons | $2,511.89 | $2,951.21 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $630.96 Median $741.31 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $630.96 | $741.31 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $645.65 Typical High $1,288.25 | Professional | AS · PA/NP assist | $549.54 | $645.65 | $1,288.25 |
CDPHP Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Emblem Health Setting Facility Modifier None Typical Low $5,011.87 Median $6,309.57 Typical High $17,782.79 | Facility | None | $5,011.87 | $6,309.57 | $17,782.79 |
Emblem Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,754.40 Typical High $9,549.93 | Professional | None | $5,011.87 | $5,754.40 | $9,549.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $4,265.80 Typical High $5,888.44 | Professional | None | $2,884.03 | $4,265.80 | $5,888.44 |
MVP Health Care Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
MVP Health Care Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $10,964.78 | Professional | None | $4,570.88 | $4,570.88 | $10,964.78 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $5,011.87 Typical High $14,454.40 | Professional | None | $3,630.78 | $5,011.87 | $14,454.40 |
Univera Setting Facility Modifier None Typical Low $3,467.37 Median $4,466.84 Typical High $13,182.57 | Facility | None | $3,467.37 | $4,466.84 | $13,182.57 |
Univera Setting Professional Modifier None Typical Low $2,884.03 Median $4,265.80 Typical High $5,754.40 | Professional | None | $2,884.03 | $4,265.80 | $5,754.40 |
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 $2,691.53 Median $2,691.53 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,691.53 | $2,691.53 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 53 · Discontinued | $1,071.52 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,981.07 Median $3,981.07 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,981.07 | $3,981.07 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | 55 · Aftercare only | $794.33 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 56 · Pre-op care only | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,715.35 Median $3,715.35 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,715.35 | $3,715.35 | $3,981.07 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,630.78 Typical High $5,623.41 | Professional | 54 · Surgery only | $2,754.23 | $3,630.78 | $5,623.41 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $588.84 Typical High $912.01 | Professional | 55 · Aftercare only | $446.68 | $588.84 | $912.01 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $426.58 Typical High $645.65 | Professional | 56 · Pre-op care only | $316.23 | $426.58 | $645.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $3,235.94 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $2,398.83 | $3,235.94 | $4,897.79 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $2,454.71 Median $3,388.44 Typical High $4,786.30 | Professional | 53 · Discontinued | $2,454.71 | $3,388.44 | $4,786.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,630.78 Typical High $5,011.87 | Professional | 54 · Surgery only | $2,754.23 | $3,630.78 | $5,011.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $588.84 Typical High $1,288.25 | Professional | 55 · Aftercare only | $446.68 | $588.84 | $1,288.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $426.58 Typical High $912.01 | Professional | 56 · Pre-op care only | $316.23 | $426.58 | $912.01 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $3,235.94 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,398.83 | $3,235.94 | $4,466.84 |
Where New York sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.