How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $10,000Professionalmedian $1,047 · 10th to 90th $851 to $1,622
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 $1,148.15 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,659.59 | Professional | None | $891.25 | $1,047.13 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,023.29 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $263.03 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $229.09 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,137.96 | Professional | None | $933.25 | $933.25 | $2,137.96 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $4,168.69 | Facility | None | $1,047.13 | $1,288.25 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,258.93 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,445.44 | Professional | None | $741.31 | $954.99 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,071.52 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,202.26 | $1,778.28 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,659.59 | Professional | None | $758.58 | $1,047.13 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $1,023.29 Typical High $3,981.07 | Facility | None | $707.95 | $1,023.29 | $3,981.07 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | None | $741.31 | $977.24 | $1,445.44 |
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 $575.44 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $537.03 | $891.25 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $144.54 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $89.13 Typical High $131.83 | Professional | 56 · Pre-op care only | $53.70 | $89.13 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $794.33 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $489.78 | $794.33 | $1,174.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $776.25 Typical High $1,047.13 | Professional | 53 · Discontinued | $575.44 | $776.25 | $1,047.13 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $537.03 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $234.42 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $89.13 Typical High $208.93 | Professional | 56 · Pre-op care only | $53.70 | $89.13 | $208.93 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $794.33 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $489.78 | $794.33 | $1,174.90 |
Where New York sits
The same service costs 10.0 times more in Maine 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
ME $17,294MD $1,737
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.