How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,471Professionalmedian $646 · 10th to 90th $513 to $1,380
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 $6,456.54 Typical High $13,182.57 | Facility | None | $1,819.70 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,659.59 | Professional | None | $758.58 | $794.33 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,258.93 | Professional | None | $537.03 | $630.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $398.11 Typical High $794.33 | Professional | 62 · Two surgeons | $338.84 | $398.11 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $100.00 Typical High $199.53 | Professional | 80 · Assistant surgeon | $85.11 | $100.00 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $87.10 Typical High $173.78 | Professional | AS · PA/NP assist | $74.13 | $87.10 | $173.78 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,445.44 | $3,890.45 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $2,754.23 | Professional | None | $616.60 | $812.83 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $724.44 Median $1,148.15 Typical High $2,570.40 | Facility | None | $724.44 | $1,148.15 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,258.93 | Professional | None | $676.08 | $758.58 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,023.29 | Professional | None | $489.78 | $602.56 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,786.30 | Facility | None | $707.95 | $707.95 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,698.24 | Professional | None | $954.99 | $954.99 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,317.64 | Facility | None | $1,122.02 | $2,754.23 | $8,317.64 |
United Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,905.46 | Professional | None | $512.86 | $707.95 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $630.96 Typical High $2,398.83 | Facility | None | $575.44 | $630.96 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,023.29 | Professional | None | $489.78 | $602.56 | $1,023.29 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $1,000.00 | Professional | 54 · Surgery only | $446.68 | $537.03 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $53.70 Typical High $100.00 | Professional | 55 · Aftercare only | $43.65 | $53.70 | $100.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $38.90 | $47.86 | $87.10 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $457.09 Typical High $707.95 | Professional | 53 · Discontinued | $346.74 | $457.09 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $1,000.00 | Professional | 54 · Surgery only | $446.68 | $537.03 | $1,000.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $53.70 Typical High $123.03 | Professional | 55 · Aftercare only | $43.65 | $53.70 | $123.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $109.65 | Professional | 56 · Pre-op care only | $38.90 | $47.86 | $109.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $912.01 |
Where New York sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $8,442KY $1,804
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.