How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,096 to $13,183Professionalmedian $1,413 · 10th to 90th $1,072 to $2,754
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 $1,548.82 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,548.82 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,348.96 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $398.11 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $354.81 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $354.81 |
CDPHP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,897.79 | Professional | None | $1,412.54 | $1,412.54 | $4,897.79 |
Emblem Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $5,248.07 | Facility | None | $1,621.81 | $2,570.40 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,698.24 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,905.46 | Professional | None | $912.01 | $1,258.93 | $1,905.46 |
MVP Health Care Setting Facility Modifier None Typical Low $1,445.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,445.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,187.76 | $3,548.13 |
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 $1,122.02 Median $1,584.89 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,584.89 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,288.25 Typical High $6,918.31 | Facility | None | $977.24 | $1,288.25 | $6,918.31 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,905.46 | Professional | None | $912.01 | $1,258.93 | $1,905.46 |
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 $776.25 Median $776.25 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 53 · Discontinued | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,174.90 Typical High $1,819.70 | Professional | 54 · Surgery only | $851.14 | $1,174.90 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $138.04 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $138.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $112.20 Typical High $177.83 | Professional | 56 · Pre-op care only | $81.28 | $112.20 | $177.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,047.13 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $758.58 | $1,047.13 | $1,659.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,174.90 Typical High $1,819.70 | Professional | 54 · Surgery only | $851.14 | $1,174.90 | $1,819.70 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $186.21 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $186.21 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $112.20 Typical High $239.88 | Professional | 56 · Pre-op care only | $81.28 | $112.20 | $239.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,047.13 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $758.58 | $1,047.13 | $1,659.59 |
Where New York sits
The same service costs 8.9 times more in Alabama than in Maryland. 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
AL $18,845MD $2,111
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.