How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,349 to $10,471Professionalmedian $1,288 · 10th to 90th $1,023 to $2,570
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 $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,513.56 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,288.25 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,513.56 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $380.19 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $331.13 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $331.13 |
CDPHP Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,737.80 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $4,466.84 | Professional | None | $1,096.48 | $1,148.15 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $4,677.35 | Facility | None | $1,202.26 | $1,548.82 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,513.56 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,819.70 | Professional | None | $870.96 | $1,148.15 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,288.25 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,162.28 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $3,890.45 | Professional | None | $1,023.29 | $1,479.11 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,230.27 Typical High $4,168.69 | Facility | None | $933.25 | $1,230.27 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,819.70 | Professional | None | $870.96 | $1,148.15 | $1,819.70 |
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 $741.31 Median $741.31 Typical High $870.96 | Professional | 52 · Reduced service | $741.31 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $131.83 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $102.33 Typical High $169.82 | Professional | 56 · Pre-op care only | $79.43 | $102.33 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $954.99 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $741.31 | $954.99 | $1,584.89 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $177.83 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $107.15 Typical High $229.09 | Professional | 56 · Pre-op care only | $79.43 | $107.15 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $741.31 | $1,000.00 | $1,584.89 |
Where New York sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.