How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,413 to $12,589Professionalmedian $955 · 10th to 90th $741 to $1,905
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 $2,137.96 Median $6,606.93 Typical High $14,791.08 | Facility | None | $2,137.96 | $6,606.93 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $3,548.13 | Professional | None | $1,071.52 | $1,071.52 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,698.24 | Professional | None | $758.58 | $912.01 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $1,071.52 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $275.42 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $239.88 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $239.88 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $5,248.07 Typical High $10,715.19 | Facility | None | $2,238.72 | $5,248.07 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $3,388.44 | Professional | None | $954.99 | $977.24 | $3,388.44 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $3,548.13 | Facility | None | $1,047.13 | $1,778.28 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,949.84 | Professional | None | $954.99 | $1,096.48 | $1,949.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,258.93 | Professional | None | $616.60 | $812.83 | $1,258.93 |
MVP Health Care Setting Facility Modifier None Typical Low $1,047.13 Median $5,754.40 Typical High $23,442.29 | Facility | None | $1,047.13 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,318.26 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $2,818.38 | Professional | None | $724.44 | $1,096.48 | $2,818.38 |
Univera Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $3,548.13 | Facility | None | $645.65 | $870.96 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,258.93 | Professional | None | $616.60 | $812.83 | $1,258.93 |
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 $537.03 Median $537.03 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $758.58 Typical High $1,230.27 | Professional | 54 · Surgery only | $575.44 | $758.58 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $93.33 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $93.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $72.44 Typical High $117.49 | Professional | 56 · Pre-op care only | $54.95 | $72.44 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $1,096.48 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $758.58 Typical High $1,230.27 | Professional | 54 · Surgery only | $575.44 | $758.58 | $1,230.27 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $58.88 Typical High $125.89 | Professional | 55 · Aftercare only | $42.66 | $58.88 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $75.86 Typical High $158.49 | Professional | 56 · Pre-op care only | $54.95 | $75.86 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $707.95 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $512.86 | $707.95 | $1,096.48 |
Where New York sits
The same service costs 4.0 times more in Wisconsin than in Montana. 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
WI $11,674MT $2,925
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.