How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,230 to $11,749Professionalmedian $617 · 10th to 90th $468 to $1,175
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 $1,621.81 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,621.81 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,348.96 | Professional | None | $676.08 | $676.08 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,096.48 | Professional | None | $478.63 | $575.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $870.96 Typical High $1,621.81 | Professional | 50 · Both sides | $724.44 | $870.96 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $363.08 Typical High $691.83 | Professional | 62 · Two surgeons | $302.00 | $363.08 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $173.78 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $81.28 Typical High $151.36 | Professional | AS · PA/NP assist | $67.61 | $81.28 | $151.36 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,445.44 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $2,187.76 | Professional | None | $616.60 | $616.60 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $2,238.72 | Facility | None | $616.60 | $812.83 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,230.27 | Professional | None | $602.56 | $691.83 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $831.76 | Professional | None | $389.05 | $512.86 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $5,754.40 | Facility | None | $676.08 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,548.82 | Professional | None | $724.44 | $724.44 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,778.28 | Professional | None | $467.74 | $691.83 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $416.87 Median $562.34 Typical High $2,398.83 | Facility | None | $416.87 | $562.34 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $831.76 | Professional | None | $389.05 | $512.86 | $831.76 |
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 $338.84 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $562.34 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $794.33 | Professional | 54 · Surgery only | $363.08 | $478.63 | $794.33 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $60.26 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $60.26 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $75.86 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $75.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $426.58 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $323.59 | $426.58 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $489.78 Typical High $776.25 | Professional | 54 · Surgery only | $363.08 | $489.78 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $79.43 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $79.43 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $47.86 Typical High $102.33 | Professional | 56 · Pre-op care only | $34.67 | $47.86 | $102.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $446.68 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $323.59 | $446.68 | $707.95 |
Where New York sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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
WI $10,313MT $1,845
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.