How much rates vary
Facilitymedian $3,311 · 10th to 90th $741 to $7,762Professionalmedian $339 · 10th to 90th $257 to $525
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 $457.09 Median $3,981.07 Typical High $8,709.64 | Facility | None | $457.09 | $3,981.07 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $457.09 | Professional | None | $338.84 | $407.38 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $549.54 | Professional | None | $281.84 | $331.13 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $501.19 Typical High $812.83 | Professional | 50 · Both sides | $426.58 | $501.19 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $87.10 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $87.10 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $46.77 Typical High $72.44 | Professional | AS · PA/NP assist | $39.81 | $46.77 | $72.44 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $660.69 | Professional | None | $218.78 | $302.00 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $1,071.52 | Facility | None | $295.12 | $371.54 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $794.33 | Professional | None | $354.81 | $457.09 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $501.19 | Professional | None | $263.03 | $363.08 | $501.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $5,495.41 | Facility | None | $1,479.11 | $2,454.71 | $5,495.41 |
MVP Health Care Setting Facility Modifier None Typical Low $295.12 Median $3,235.94 Typical High $4,365.16 | Facility | None | $295.12 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $575.44 | Professional | None | $338.84 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,148.15 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $489.78 | Professional | None | $213.80 | $309.03 | $489.78 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $354.81 Typical High $977.24 | Facility | None | $181.97 | $354.81 | $977.24 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $501.19 | Professional | None | $263.03 | $363.08 | $501.19 |
15 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 $169.82 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $169.82 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $316.23 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $331.13 Typical High $457.09 | Professional | 54 · Surgery only | $190.55 | $331.13 | $457.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $20.89 | $37.15 | $50.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $33.11 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.05 | $33.11 | $45.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $295.12 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $169.82 | $295.12 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $257.04 Typical High $389.05 | Professional | 53 · Discontinued | $199.53 | $257.04 | $389.05 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $331.13 Typical High $457.09 | Professional | 54 · Surgery only | $190.55 | $331.13 | $457.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $37.15 Typical High $79.43 | Professional | 55 · Aftercare only | $20.89 | $37.15 | $79.43 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $33.11 Typical High $70.79 | Professional | 56 · Pre-op care only | $19.05 | $33.11 | $70.79 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $295.12 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $169.82 | $295.12 | $407.38 |
Where New York sits
The same service costs 5.5 times more in Alabama than in North Dakota. 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 $5,448ND $992
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.