How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,148 to $12,303Professionalmedian $1,950 · 10th to 90th $1,479 to $2,630
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 $1,862.09 Median $6,309.57 Typical High $13,489.63 | Facility | None | $1,862.09 | $6,309.57 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,137.96 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,621.81 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,659.59 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,230.27 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,047.13 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $316.23 Typical High $416.87 | Professional | 80 · Assistant surgeon | $269.15 | $316.23 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $275.42 Typical High $363.08 | Professional | AS · PA/NP assist | $234.42 | $275.42 | $363.08 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
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 $851.14 Median $1,778.28 Typical High $3,981.07 | Facility | None | $851.14 | $1,778.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,479.11 | $3,467.37 |
Emblem Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $6,456.54 | Facility | None | $1,778.28 | $2,187.76 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,388.44 | Professional | None | $1,659.59 | $1,659.59 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
Highmark BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,511.89 | $3,311.31 | $4,365.16 |
MVP Health Care Setting Facility Modifier None Typical Low $1,819.70 Median $6,456.54 Typical High $7,079.46 | Facility | None | $1,819.70 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,995.26 | $1,995.26 | $2,884.03 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,760.83 | Facility | None | $575.44 | $1,778.28 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,698.24 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $6,309.57 | Facility | None | $1,148.15 | $1,659.59 | $6,309.57 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
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 $933.25 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $933.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,412.54 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $186.21 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,513.56 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,412.54 Typical High $2,137.96 | Professional | 54 · Surgery only | $870.96 | $1,412.54 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $154.88 Typical High $234.42 | Professional | 55 · Aftercare only | $97.72 | $154.88 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $141.25 Typical High $213.80 | Professional | 56 · Pre-op care only | $87.10 | $141.25 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,905.46 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $1,258.93 Typical High $1,698.24 | Professional | 53 · Discontinued | $954.99 | $1,258.93 | $1,698.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,412.54 Typical High $2,137.96 | Professional | 54 · Surgery only | $870.96 | $1,412.54 | $2,137.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $154.88 Typical High $380.19 | Professional | 55 · Aftercare only | $97.72 | $154.88 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $141.25 Typical High $338.84 | Professional | 56 · Pre-op care only | $87.10 | $141.25 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,905.46 |
Where New York sits
The same service costs 6.0 times more in Alaska than in Maryland. 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 $14,920MD $2,468
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.