How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,413 to $12,882Professionalmedian $832 · 10th to 90th $676 to $1,820
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 $13,489.63 | Facility | None | $1,819.70 | $6,309.57 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,122.02 | $2,454.71 |
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 $676.08 Median $794.33 Typical High $1,621.81 | Professional | None | $676.08 | $794.33 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $2,454.71 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $1,023.29 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $263.03 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $229.09 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $229.09 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $8,511.38 Typical High $17,782.79 | Facility | None | $1,479.11 | $8,511.38 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $3,715.35 | Professional | None | $794.33 | $1,071.52 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,388.44 | Facility | None | $954.99 | $1,479.11 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,659.59 | Professional | None | $870.96 | $1,000.00 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,445.44 | Professional | None | $645.65 | $794.33 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $6,456.54 Typical High $7,079.46 | Facility | None | $1,000.00 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,174.90 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,589.25 | Facility | None | $1,318.26 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $2,511.89 | Professional | None | $676.08 | $954.99 | $2,511.89 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $812.83 Typical High $3,235.94 | Facility | None | $758.58 | $812.83 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,445.44 | Professional | None | $645.65 | $794.33 | $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 $524.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $776.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | 54 · Surgery only | $588.84 | $724.44 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $134.90 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $120.23 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $120.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $660.69 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $537.03 | $660.69 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $616.60 Typical High $933.25 | Professional | 53 · Discontinued | $467.74 | $616.60 | $933.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $1,318.26 | Professional | 54 · Surgery only | $588.84 | $724.44 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $162.18 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $162.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $144.54 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $144.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $660.69 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $537.03 | $660.69 | $1,202.26 |
Where New York sits
The same service costs 4.6 times more in Wyoming than in Montana. 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
WY $13,103MT $2,825
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.