How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $10,965Professionalmedian $1,288 · 10th to 90th $977 to $2,512
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 $1,445.44 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,445.44 | $2,818.38 |
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 $1,023.29 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,230.27 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,862.09 Typical High $3,548.13 | Professional | 50 · Both sides | $1,548.82 | $1,862.09 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $776.25 Typical High $1,513.56 | Professional | 62 · Two surgeons | $645.65 | $776.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $380.19 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $331.13 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $331.13 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,318.26 Median $1,318.26 Typical High $4,677.35 | Professional | None | $1,318.26 | $1,318.26 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $4,570.88 | Facility | None | $1,412.54 | $2,089.30 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,479.11 | $2,630.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,778.28 | Professional | None | $831.76 | $1,096.48 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,445.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,445.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,862.09 | $1,862.09 | $3,311.31 |
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 $1,000.00 Median $1,445.44 Typical High $3,801.89 | Professional | None | $1,000.00 | $1,445.44 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $5,011.87 | Facility | None | $891.25 | $1,174.90 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,778.28 | Professional | None | $831.76 | $1,096.48 | $1,778.28 |
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 $724.44 Median $724.44 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,023.29 Typical High $1,698.24 | Professional | 54 · Surgery only | $776.25 | $1,023.29 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $75.86 Typical High $128.82 | Professional | 55 · Aftercare only | $57.54 | $75.86 | $128.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $97.72 Typical High $165.96 | Professional | 56 · Pre-op care only | $74.13 | $97.72 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $912.01 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $691.83 | $912.01 | $1,548.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,659.59 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $79.43 Typical High $169.82 | Professional | 55 · Aftercare only | $57.54 | $79.43 | $169.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $102.33 Typical High $218.78 | Professional | 56 · Pre-op care only | $74.13 | $102.33 | $218.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $691.83 | $954.99 | $1,513.56 |
Where New York sits
The same service costs 8.1 times more in Maine 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
ME $15,945MD $1,975
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.