How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,125Professionalmedian $2,570 · 10th to 90th $1,950 to $5,012
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 $2,818.38 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,818.38 | $2,818.38 | $4,677.35 |
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 $2,041.74 Median $2,454.71 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,454.71 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,548.82 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,288.25 | $1,548.82 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $389.05 Typical High $741.31 | Professional | 80 · Assistant surgeon | $323.59 | $389.05 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $346.74 Typical High $645.65 | Professional | AS · PA/NP assist | $281.84 | $346.74 | $645.65 |
CDPHP Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,265.80 | Facility | None | $851.14 | $1,778.28 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $8,912.51 | Professional | None | $2,570.40 | $2,630.27 | $8,912.51 |
Emblem Health Setting Facility Modifier None Typical Low $2,570.40 Median $3,715.35 Typical High $9,332.54 | Facility | None | $2,570.40 | $3,715.35 | $9,332.54 |
Emblem Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $5,370.32 | Professional | None | $2,818.38 | $3,019.95 | $5,370.32 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,238.72 | $3,548.13 |
MVP Health Care Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,606.93 | Professional | None | $3,019.95 | $3,019.95 | $6,606.93 |
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 $2,041.74 Median $2,884.03 Typical High $7,585.78 | Professional | None | $2,041.74 | $2,884.03 | $7,585.78 |
Univera Setting Facility Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $7,943.28 | Facility | None | $1,778.28 | $1,862.09 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,238.72 | $3,548.13 |
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 $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 53 · Discontinued | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $501.19 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,344.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,089.30 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,548.82 | $2,089.30 | $3,467.37 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $158.49 Typical High $257.04 | Professional | 55 · Aftercare only | $117.49 | $158.49 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $204.17 Typical High $331.13 | Professional | 56 · Pre-op care only | $151.36 | $204.17 | $331.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,905.46 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,905.46 | $3,090.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,089.30 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,548.82 | $2,089.30 | $3,311.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $158.49 Typical High $338.84 | Professional | 55 · Aftercare only | $117.49 | $158.49 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $204.17 Typical High $436.52 | Professional | 56 · Pre-op care only | $151.36 | $204.17 | $436.52 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,905.46 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,905.46 | $3,019.95 |
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 $22,023WA $3,113
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.