How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,445 to $38,905Professionalmedian $1,072 · 10th to 90th $871 to $1,660
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 $6,309.57 Typical High $18,197.01 | Facility | None | $1,819.70 | $6,309.57 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,174.90 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,481.54 Typical High $43,651.58 | Facility | None | $1,737.80 | $11,481.54 | $43,651.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,659.59 | Professional | None | $912.01 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $676.08 Typical High $1,000.00 | Professional | 62 · Two surgeons | $575.44 | $676.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $257.04 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $223.87 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $223.87 |
CDPHP Setting Facility Modifier None Typical Low $6,606.93 Median $9,332.54 Typical High $28,183.83 | Facility | None | $6,606.93 | $9,332.54 | $28,183.83 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $16,218.10 Typical High $37,153.52 | Facility | None | $1,778.28 | $16,218.10 | $37,153.52 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $2,137.96 | Professional | None | $954.99 | $977.24 | $2,137.96 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $4,466.84 Typical High $50,118.72 | Facility | None | $1,202.26 | $4,466.84 | $50,118.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,288.25 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,479.11 | Professional | None | $758.58 | $977.24 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $6,456.54 Median $13,489.63 Typical High $31,622.78 | Facility | None | $6,456.54 | $13,489.63 | $31,622.78 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $5,495.41 Typical High $23,988.33 | Facility | None | $1,318.26 | $5,495.41 | $23,988.33 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $3,235.94 | Facility | None | $707.95 | $1,071.52 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,445.44 | Professional | None | $758.58 | $1,000.00 | $1,445.44 |
10 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 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $912.01 Typical High $1,318.26 | Professional | 54 · Surgery only | $549.54 | $912.01 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $147.91 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $91.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $54.95 | $91.20 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $812.83 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $776.25 Typical High $1,071.52 | Professional | 53 · Discontinued | $588.84 | $776.25 | $1,071.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $912.01 Typical High $1,318.26 | Professional | 54 · Surgery only | $549.54 | $912.01 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $239.88 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $239.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $91.20 Typical High $213.80 | Professional | 56 · Pre-op care only | $54.95 | $91.20 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $812.83 | $1,202.26 |
Where New York sits
The same service costs 6.5 times more in Alaska than in West Virginia. 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
AK $17,292WV $2,643
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.