How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $10,965Professionalmedian $1,259 · 10th to 90th $977 to $2,455
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,412.54 | $2,884.03 |
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 $1,000.00 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,230.27 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $3,467.37 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $1,445.44 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $363.08 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $323.59 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,288.25 Median $1,318.26 Typical High $4,466.84 | Professional | None | $1,288.25 | $1,318.26 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $4,466.84 | Facility | None | $1,288.25 | $2,137.96 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,380.38 | $2,454.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,584.89 | Professional | None | $776.25 | $1,023.29 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,479.11 | $3,235.94 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,801.89 | Professional | None | $912.01 | $1,445.44 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,174.90 Typical High $4,786.30 | Facility | None | $812.83 | $1,174.90 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,584.89 | Professional | None | $776.25 | $1,023.29 | $1,584.89 |
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 $707.95 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $954.99 Typical High $1,548.82 | Professional | 54 · Surgery only | $724.44 | $954.99 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $70.79 Typical High $117.49 | Professional | 55 · Aftercare only | $53.70 | $70.79 | $117.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $91.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $69.18 | $91.20 | $147.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $851.14 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $645.65 | $851.14 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $954.99 Typical High $1,479.11 | Professional | 54 · Surgery only | $724.44 | $954.99 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $74.13 Typical High $158.49 | Professional | 55 · Aftercare only | $53.70 | $74.13 | $158.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $95.50 Typical High $199.53 | Professional | 56 · Pre-op care only | $69.18 | $95.50 | $199.53 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $891.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $645.65 | $891.25 | $1,348.96 |
Where New York sits
The same service costs 6.4 times more in Alaska 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
AK $12,091MD $1,881
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.