How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,230 to $8,128Professionalmedian $1,148 · 10th to 90th $891 to $2,512
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $3,548.13 | Professional | None | $1,023.29 | $1,412.54 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,187.76 | Professional | None | $912.01 | $1,071.52 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $676.08 Typical High $1,380.38 | Professional | 62 · Two surgeons | $575.44 | $676.08 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $354.81 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $309.03 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $309.03 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,737.80 | $3,890.45 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $5,011.87 | Professional | None | $1,122.02 | $1,230.27 | $5,011.87 |
Emblem Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,148.15 | $2,089.30 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,288.25 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,548.82 | Professional | None | $794.33 | $1,000.00 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $4,786.30 | Facility | None | $1,174.90 | $1,174.90 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,288.25 | $2,884.03 |
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 $851.14 Median $1,479.11 Typical High $3,090.30 | Professional | None | $851.14 | $1,479.11 | $3,090.30 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $3,630.78 | Facility | None | $851.14 | $1,071.52 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,513.56 | Professional | None | $794.33 | $1,000.00 | $1,513.56 |
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 $512.86 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $512.86 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $204.17 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $102.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $724.44 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $851.14 Typical High $1,445.44 | Professional | 54 · Surgery only | $676.08 | $851.14 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $234.42 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $123.03 Typical High $199.53 | Professional | 56 · Pre-op care only | $95.50 | $123.03 | $199.53 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $758.58 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $588.84 | $758.58 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $794.33 Typical High $1,202.26 | Professional | 53 · Discontinued | $602.56 | $794.33 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $676.08 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $323.59 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $123.03 Typical High $275.42 | Professional | 56 · Pre-op care only | $95.50 | $123.03 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $758.58 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $588.84 | $758.58 | $1,122.02 |
Where New York sits
The same service costs 4.4 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 $10,675KY $2,405
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.