How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,148 to $10,965Professionalmedian $1,585 · 10th to 90th $1,259 to $3,162
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 $1,819.70 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,819.70 | $1,819.70 | $3,715.35 |
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 $1,288.25 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,548.82 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,344.23 Typical High $4,365.16 | Professional | 50 · Both sides | $1,949.84 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,862.09 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $467.74 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $218.78 Typical High $407.38 | Professional | AS · PA/NP assist | $181.97 | $218.78 | $407.38 |
CDPHP Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,659.59 Median $1,659.59 Typical High $5,754.40 | Professional | None | $1,659.59 | $1,659.59 | $5,754.40 |
Emblem Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $5,888.44 | Facility | None | $1,621.81 | $1,995.26 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,659.59 | $1,905.46 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,412.54 | $2,238.72 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,737.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $4,168.69 | Professional | None | $1,479.11 | $1,479.11 | $4,168.69 |
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 $1,258.93 Median $1,862.09 Typical High $4,897.79 | Professional | None | $1,258.93 | $1,862.09 | $4,897.79 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $5,754.40 | Facility | None | $1,148.15 | $1,513.56 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,412.54 | $2,238.72 |
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 $912.01 Median $912.01 Typical High $1,071.52 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 53 · Discontinued | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,288.25 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,000.00 | $1,288.25 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $97.72 Typical High $162.18 | Professional | 55 · Aftercare only | $74.13 | $97.72 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $125.89 Typical High $208.93 | Professional | 56 · Pre-op care only | $95.50 | $125.89 | $208.93 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,174.90 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $891.25 | $1,174.90 | $1,949.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,348.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,000.00 | $1,348.96 | $2,137.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $102.33 Typical High $218.78 | Professional | 55 · Aftercare only | $74.13 | $102.33 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $131.83 Typical High $275.42 | Professional | 56 · Pre-op care only | $95.50 | $131.83 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,230.27 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $891.25 | $1,230.27 | $1,949.84 |
Where New York sits
The same service costs 8.2 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 $19,170WA $2,342
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.