How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $10,715Professionalmedian $562 · 10th to 90th $468 to $1,259
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 $1,513.56 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,513.56 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,659.59 | Professional | None | $724.44 | $776.25 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $1,122.02 | Professional | None | $467.74 | $549.54 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $346.74 Typical High $707.95 | Professional | 62 · Two surgeons | $295.12 | $346.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $89.13 Typical High $181.97 | Professional | 80 · Assistant surgeon | $75.86 | $89.13 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $158.49 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $158.49 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,466.84 Typical High $8,912.51 | Facility | None | $1,148.15 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $2,454.71 | Professional | None | $549.54 | $676.08 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,398.83 | Facility | None | $660.69 | $776.25 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,148.15 | Professional | None | $616.60 | $707.95 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $1,023.29 | Professional | None | $446.68 | $549.54 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,786.30 | Facility | None | $691.83 | $691.83 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,548.82 | Professional | None | $870.96 | $870.96 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,737.80 | Professional | None | $467.74 | $660.69 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $562.34 Typical High $2,290.87 | Facility | None | $524.81 | $562.34 | $2,290.87 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $1,000.00 | Professional | None | $446.68 | $549.54 | $1,000.00 |
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 $363.08 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $537.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $954.99 | Professional | 54 · Surgery only | $407.38 | $501.19 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $93.33 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $93.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $83.18 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $83.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $457.09 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $371.54 | $457.09 | $870.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $426.58 Typical High $645.65 | Professional | 53 · Discontinued | $323.59 | $426.58 | $645.65 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $912.01 | Professional | 54 · Surgery only | $407.38 | $501.19 | $912.01 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $112.20 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $112.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $100.00 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $100.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $457.09 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $371.54 | $457.09 | $831.76 |
Where New York sits
The same service costs 4.4 times more in Alabama 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
AL $8,633MT $1,977
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.