How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,175 to $11,749Professionalmedian $1,950 · 10th to 90th $1,479 to $3,715
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 $2,089.30 Median $2,089.30 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,089.30 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,819.70 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $295.12 Typical High $562.34 | Professional | 80 · Assistant surgeon | $245.47 | $295.12 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $257.04 Typical High $489.78 | Professional | AS · PA/NP assist | $213.80 | $257.04 | $489.78 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $6,456.54 | Professional | None | $1,949.84 | $1,995.26 | $6,456.54 |
Emblem Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $6,918.31 | Facility | None | $1,949.84 | $2,630.27 | $6,918.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,238.72 | $3,981.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,659.59 | $2,691.53 |
MVP Health Care Setting Facility Modifier None Typical Low $2,344.23 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,344.23 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $5,011.87 | Professional | None | $3,090.30 | $3,388.44 | $5,011.87 |
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 $1,513.56 Median $2,137.96 Typical High $5,754.40 | Professional | None | $1,513.56 | $2,137.96 | $5,754.40 |
Univera Setting Facility Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,388.44 | Facility | None | $1,348.96 | $1,778.28 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,659.59 | $2,691.53 |
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 $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $512.86 | Professional | 53 · Discontinued | $416.87 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,548.82 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,174.90 | $1,548.82 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $117.49 Typical High $194.98 | Professional | 55 · Aftercare only | $89.13 | $117.49 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $151.36 Typical High $251.19 | Professional | 56 · Pre-op care only | $112.20 | $151.36 | $251.19 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,412.54 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,412.54 | $2,344.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,584.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,174.90 | $1,584.89 | $2,511.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $120.23 Typical High $245.47 | Professional | 55 · Aftercare only | $89.13 | $120.23 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $154.88 Typical High $316.23 | Professional | 56 · Pre-op care only | $112.20 | $154.88 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,445.44 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,445.44 | $2,290.87 |
Where New York sits
The same service costs 8.0 times more in Alabama 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
AL $20,353WA $2,540
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.