How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $10,965Professionalmedian $1,995 · 10th to 90th $1,585 to $4,074
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 $2,290.87 Median $2,290.87 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,290.87 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,022.64 | Facility | None | $1,698.24 | $6,309.57 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,659.59 | $1,995.26 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,951.21 Typical High $5,623.41 | Professional | 50 · Both sides | $2,454.71 | $2,951.21 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,258.93 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,047.13 | $1,258.93 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $316.23 Typical High $602.56 | Professional | 80 · Assistant surgeon | $263.03 | $316.23 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $275.42 Typical High $524.81 | Professional | AS · PA/NP assist | $229.09 | $275.42 | $524.81 |
CDPHP Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,388.44 | Facility | None | $851.14 | $1,778.28 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $7,079.46 | Professional | None | $2,089.30 | $2,137.96 | $7,079.46 |
Emblem Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $7,413.10 | Facility | None | $1,995.26 | $2,511.89 | $7,413.10 |
Emblem Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $4,265.80 | Professional | None | $2,089.30 | $2,398.83 | $4,265.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,819.70 | $2,818.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,949.84 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,949.84 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $5,370.32 | Professional | None | $1,698.24 | $1,698.24 | $5,370.32 |
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 $1,548.82 Median $2,290.87 Typical High $6,165.95 | Professional | None | $1,548.82 | $2,290.87 | $6,165.95 |
Univera Setting Facility Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $5,128.61 | Facility | None | $1,445.44 | $1,905.46 | $5,128.61 |
Univera Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,819.70 | $2,818.38 |
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 $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,258.93 | $1,659.59 | $2,754.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $125.89 Typical High $204.17 | Professional | 55 · Aftercare only | $95.50 | $125.89 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $162.18 Typical High $263.03 | Professional | 56 · Pre-op care only | $123.03 | $162.18 | $263.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,513.56 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,513.56 | $2,454.71 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,258.93 | $1,659.59 | $2,754.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $128.82 Typical High $275.42 | Professional | 55 · Aftercare only | $95.50 | $128.82 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $165.96 Typical High $354.81 | Professional | 56 · Pre-op care only | $123.03 | $165.96 | $354.81 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,548.82 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,548.82 | $2,454.71 |
Where New York sits
The same service costs 7.2 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 $19,737WA $2,745
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.