How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,660 to $32,359Professionalmedian $1,950 · 10th to 90th $1,549 to $2,754
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 $1,905.46 Median $6,606.93 Typical High $22,387.21 | Facility | None | $1,905.46 | $6,606.93 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,905.46 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $30,902.95 | Facility | None | $1,778.28 | $8,511.38 | $30,902.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,089.30 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,318.26 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,096.48 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $436.52 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $380.19 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $380.19 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $25,118.86 Typical High $38,018.94 | Facility | None | $1,318.26 | $25,118.86 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,548.82 | $1,548.82 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $2,089.30 Median $6,025.60 Typical High $50,118.72 | Facility | None | $2,089.30 | $6,025.60 | $50,118.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,041.74 | $3,630.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,621.81 | $2,454.71 |
MVP Health Care Setting Facility Modifier None Typical Low $1,819.70 Median $13,489.63 Typical High $31,622.78 | Facility | None | $1,819.70 | $13,489.63 | $31,622.78 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,819.70 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,365.16 Typical High $23,442.29 | Facility | None | $1,318.26 | $4,365.16 | $23,442.29 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,737.80 | $2,818.38 |
Univera Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,737.80 | $5,495.41 |
Univera Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,621.81 | $2,454.71 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,548.82 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,445.44 Typical High $2,238.72 | Professional | 54 · Surgery only | $891.25 | $1,445.44 | $2,238.72 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $162.18 Typical High $245.47 | Professional | 55 · Aftercare only | $100.00 | $162.18 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $144.54 Typical High $223.87 | Professional | 56 · Pre-op care only | $89.13 | $144.54 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,318.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $812.83 | $1,318.26 | $1,995.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,445.44 Typical High $2,238.72 | Professional | 54 · Surgery only | $891.25 | $1,445.44 | $2,238.72 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $162.18 Typical High $354.81 | Professional | 55 · Aftercare only | $100.00 | $162.18 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $144.54 Typical High $323.59 | Professional | 56 · Pre-op care only | $89.13 | $144.54 | $323.59 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,318.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $812.83 | $1,318.26 | $1,995.26 |
Where New York sits
The same service costs 7.2 times more in Maine than in Delaware. 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 $28,702DE $3,966
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.