How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,125Professionalmedian $2,344 · 10th to 90th $1,820 to $4,786
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,754.23 | $2,754.23 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,479.11 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,230.27 | $1,479.11 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $380.19 Typical High $707.95 | Professional | 80 · Assistant surgeon | $316.23 | $380.19 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $331.13 Typical High $616.60 | Professional | AS · PA/NP assist | $275.42 | $331.13 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,073.80 | Facility | None | $851.14 | $1,778.28 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $8,511.38 | Professional | None | $2,454.71 | $2,511.89 | $8,511.38 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $8,912.51 | Facility | None | $1,513.56 | $2,754.23 | $8,912.51 |
Emblem Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,511.89 | $2,884.03 | $4,786.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,445.44 | $2,137.96 | $3,467.37 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,290.87 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $6,309.57 | Professional | None | $1,819.70 | $1,819.70 | $6,309.57 |
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 $1,778.28 Median $2,754.23 Typical High $7,244.36 | Professional | None | $1,778.28 | $2,754.23 | $7,244.36 |
Univera Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $6,918.31 | Facility | None | $1,698.24 | $2,238.72 | $6,918.31 |
Univera Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,445.44 | $2,137.96 | $3,467.37 |
14 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 $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 53 · Discontinued | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,905.46 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,995.26 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,479.11 | $1,995.26 | $3,311.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $245.47 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $190.55 Typical High $316.23 | Professional | 56 · Pre-op care only | $144.54 | $190.55 | $316.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,778.28 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,778.28 | $2,951.21 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,041.74 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,479.11 | $2,041.74 | $3,235.94 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $323.59 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $194.98 Typical High $416.87 | Professional | 56 · Pre-op care only | $144.54 | $194.98 | $416.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,819.70 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,819.70 | $2,884.03 |
Where New York sits
The same service costs 7.1 times more in Alaska than in Washington. 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 $21,795WA $3,089
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.