How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $9,333Professionalmedian $427 · 10th to 90th $339 to $813
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 $1,513.56 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,513.56 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,584.89 | Professional | None | $478.63 | $478.63 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,715.19 | Facility | None | $1,513.56 | $4,466.84 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $741.31 | Professional | None | $354.81 | $426.58 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $645.65 Typical High $1,096.48 | Professional | 50 · Both sides | $537.03 | $645.65 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $67.61 Typical High $117.49 | Professional | 80 · Assistant surgeon | $56.23 | $67.61 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $60.26 Typical High $102.33 | Professional | AS · PA/NP assist | $50.12 | $60.26 | $102.33 |
CDPHP Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,412.54 | Professional | None | $426.58 | $426.58 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $1,584.89 | Facility | None | $446.68 | $616.60 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $794.33 | Professional | None | $426.58 | $478.63 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $588.84 | Professional | None | $275.42 | $354.81 | $588.84 |
MVP Health Care Setting Facility Modifier None Typical Low $524.81 Median $3,235.94 Typical High $4,365.16 | Facility | None | $524.81 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,071.52 | Professional | None | $389.05 | $389.05 | $1,071.52 |
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 $323.59 Median $467.74 Typical High $1,230.27 | Professional | None | $323.59 | $467.74 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $602.56 | Facility | None | $295.12 | $389.05 | $602.56 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $575.44 | Professional | None | $275.42 | $354.81 | $575.44 |
12 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 |
|---|---|---|---|---|---|
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $562.34 | Professional | 54 · Surgery only | $257.04 | $331.13 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $42.66 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $42.66 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $54.95 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $54.95 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $512.86 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $371.54 Typical High $489.78 | Facility | 54 · Surgery only | $269.15 | $371.54 | $489.78 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $33.11 Typical High $37.15 | Facility | 55 · Aftercare only | $20.42 | $33.11 | $37.15 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $42.66 Typical High $47.86 | Facility | 56 · Pre-op care only | $26.30 | $42.66 | $47.86 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $338.84 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $245.47 | $338.84 | $446.68 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $346.74 Typical High $549.54 | Professional | 54 · Surgery only | $257.04 | $346.74 | $549.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $53.70 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $53.70 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $24.55 | $33.88 | $69.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $501.19 |
Where New York sits
The same service costs 7.2 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 $7,377MD $1,030
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.