How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $10,965Professionalmedian $1,698 · 10th to 90th $1,349 to $3,388
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 $1,949.84 Median $1,949.84 Typical High $4,265.80 | Professional | None | $1,949.84 | $1,949.84 | $4,265.80 |
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 $1,412.54 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,698.24 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,511.89 Typical High $4,677.35 | Professional | 50 · Both sides | $2,089.30 | $2,511.89 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $501.19 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $436.52 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $436.52 |
CDPHP Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,778.28 Median $1,778.28 Typical High $6,025.60 | Professional | None | $1,778.28 | $1,778.28 | $6,025.60 |
Emblem Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,344.23 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,995.26 | $3,548.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,479.11 | $2,454.71 |
MVP Health Care Setting Facility Modifier None Typical Low $1,819.70 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,819.70 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,466.84 | Professional | None | $1,412.54 | $1,412.54 | $4,466.84 |
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 $1,348.96 Median $1,949.84 Typical High $5,248.07 | Professional | None | $1,348.96 | $1,949.84 | $5,248.07 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $5,623.41 | Facility | None | $1,202.26 | $1,621.81 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,479.11 | $2,454.71 |
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 $954.99 Median $954.99 Typical High $1,148.15 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 53 · Discontinued | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,380.38 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,047.13 | $1,380.38 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $102.33 Typical High $173.78 | Professional | 55 · Aftercare only | $79.43 | $102.33 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $131.83 Typical High $223.87 | Professional | 56 · Pre-op care only | $102.33 | $131.83 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,230.27 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $954.99 | $1,230.27 | $2,089.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,445.44 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,047.13 | $1,445.44 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $107.15 Typical High $229.09 | Professional | 55 · Aftercare only | $79.43 | $107.15 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $138.04 Typical High $295.12 | Professional | 56 · Pre-op care only | $102.33 | $138.04 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,288.25 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $954.99 | $1,288.25 | $2,041.74 |
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 $19,273WA $2,428
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.