How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $1,862 · 10th to 90th $1,413 to $3,631
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 $4,265.80 | Professional | None | $2,089.30 | $2,089.30 | $4,265.80 |
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 $1,479.11 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,479.11 | $1,778.28 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,122.02 Typical High $2,089.30 | Professional | 62 · Two surgeons | $933.25 | $1,122.02 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $281.84 Typical High $537.03 | Professional | 80 · Assistant surgeon | $234.42 | $281.84 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $467.74 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,090.30 | Facility | None | $851.14 | $1,778.28 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $6,456.54 | Professional | None | $1,862.09 | $1,905.46 | $6,456.54 |
Emblem Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,548.13 Typical High $7,244.36 | Facility | None | $2,137.96 | $3,548.13 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,238.72 | $3,890.45 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,659.59 | $2,511.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
MVP Health Care Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,884.03 | $2,884.03 | $4,786.30 |
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 $1,479.11 Median $2,137.96 Typical High $5,495.41 | Professional | None | $1,479.11 | $2,137.96 | $5,495.41 |
Univera Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $7,585.78 | Facility | None | $1,288.25 | $1,698.24 | $7,585.78 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,659.59 | $2,511.89 |
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 $1,230.27 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 53 · Discontinued | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,513.56 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,122.02 | $1,513.56 | $2,454.71 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $181.97 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $181.97 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $234.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,187.76 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,513.56 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,122.02 | $1,513.56 | $2,454.71 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $245.47 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $316.23 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,187.76 |
Where New York sits
The same service costs 7.9 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 $20,238WA $2,549
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.