How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,318 to $11,749Professionalmedian $794 · 10th to 90th $631 to $1,585
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,238.72 | Professional | None | $933.25 | $933.25 | $2,238.72 |
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 $660.69 Median $794.33 Typical High $1,445.44 | Professional | None | $660.69 | $794.33 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $501.19 Typical High $912.01 | Professional | 62 · Two surgeons | $416.87 | $501.19 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $125.89 Typical High $234.42 | Professional | 80 · Assistant surgeon | $104.71 | $125.89 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $199.53 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $199.53 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,348.96 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $2,344.23 | Professional | None | $676.08 | $691.83 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $977.24 Typical High $3,090.30 | Facility | None | $794.33 | $977.24 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,659.59 | Professional | None | $812.83 | $933.25 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,122.02 | Professional | None | $446.68 | $691.83 | $1,122.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Facility | None | $10,964.78 | $10,964.78 | $10,964.78 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $4,786.30 Typical High $5,754.40 | Facility | None | $707.95 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,089.30 | Professional | None | $724.44 | $724.44 | $2,089.30 |
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 $630.96 Median $912.01 Typical High $2,398.83 | Professional | None | $630.96 | $912.01 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $2,454.71 | Facility | None | $562.34 | $741.31 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,122.02 | Professional | None | $446.68 | $691.83 | $1,122.02 |
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 $467.74 Median $467.74 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $645.65 Typical High $1,071.52 | Professional | 54 · Surgery only | $489.78 | $645.65 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $48.98 Typical High $81.28 | Professional | 55 · Aftercare only | $37.15 | $48.98 | $81.28 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $63.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $47.86 | $63.10 | $104.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $588.84 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $446.68 | $588.84 | $977.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $660.69 Typical High $1,047.13 | Professional | 54 · Surgery only | $489.78 | $660.69 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $50.12 Typical High $107.15 | Professional | 55 · Aftercare only | $37.15 | $50.12 | $107.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $64.57 Typical High $138.04 | Professional | 56 · Pre-op care only | $47.86 | $64.57 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $602.56 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $446.68 | $602.56 | $954.99 |
Where New York sits
The same service costs 4.5 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 $11,009MT $2,436
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.