How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,585 · 10th to 90th $1,288 to $2,455
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 $1,737.80 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,995.26 | $1,995.26 |
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 $1,348.96 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,584.89 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,548.82 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $389.05 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $346.74 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $346.74 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $1,445.44 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,445.44 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $6,165.95 | Facility | None | $1,513.56 | $1,905.46 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,584.89 | $1,862.09 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,479.11 | $2,238.72 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,621.81 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,513.56 | $2,344.23 |
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 $1,174.90 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,584.89 | $2,511.89 |
Univera Setting Facility Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $4,570.88 | Facility | None | $1,047.13 | $1,584.89 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,479.11 | $2,238.72 |
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 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,318.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $812.83 | $1,318.26 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $147.91 Typical High $223.87 | Professional | 55 · Aftercare only | $89.13 | $147.91 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $131.83 Typical High $199.53 | Professional | 56 · Pre-op care only | $81.28 | $131.83 | $199.53 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,174.90 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $724.44 | $1,174.90 | $1,819.70 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,318.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $812.83 | $1,318.26 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $147.91 Typical High $323.59 | Professional | 55 · Aftercare only | $89.13 | $147.91 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $131.83 Typical High $288.40 | Professional | 56 · Pre-op care only | $81.28 | $131.83 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,174.90 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $724.44 | $1,174.90 | $1,819.70 |
Where New York sits
The same service costs 8.0 times more in Maine than in Texas. 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 $18,037TX $2,258
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.