How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,288 to $15,136Professionalmedian $1,000 · 10th to 90th $776 to $2,042
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 $12,882.50 | Facility | None | $1,819.70 | $6,456.54 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,454.71 | Professional | None | $831.76 | $1,202.26 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $7,079.46 Typical High $19,498.45 | Facility | None | $1,819.70 | $7,079.46 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,819.70 | Professional | None | $812.83 | $954.99 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $1,148.15 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $288.40 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $257.04 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $257.04 |
CDPHP Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $912.01 Median $1,047.13 Typical High $3,630.78 | Professional | None | $912.01 | $1,047.13 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $1,071.52 Typical High $3,388.44 | Facility | None | $794.33 | $1,071.52 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,905.46 | Professional | None | $954.99 | $1,071.52 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,380.38 | Professional | None | $645.65 | $831.76 | $1,380.38 |
Highmark BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | AS · PA/NP assist | $323.59 | $323.59 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $4,786.30 | Facility | None | $977.24 | $977.24 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,445.44 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $2,511.89 | Professional | None | $724.44 | $1,230.27 | $2,511.89 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $870.96 Typical High $3,311.31 | Facility | None | $707.95 | $870.96 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,258.93 | Professional | None | $645.65 | $831.76 | $1,258.93 |
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 $416.87 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $416.87 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $630.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $125.89 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $588.84 | $831.76 | $831.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $707.95 Typical High $1,202.26 | Professional | 54 · Surgery only | $562.34 | $707.95 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $194.98 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $100.00 Typical High $169.82 | Professional | 56 · Pre-op care only | $77.62 | $100.00 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $616.60 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $478.63 | $616.60 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $660.69 Typical High $977.24 | Professional | 53 · Discontinued | $489.78 | $660.69 | $977.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $562.34 | $724.44 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $117.49 Typical High $263.03 | Professional | 55 · Aftercare only | $91.20 | $117.49 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $100.00 Typical High $223.87 | Professional | 56 · Pre-op care only | $77.62 | $100.00 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $478.63 | $616.60 | $1,023.29 |
Where New York sits
The same service costs 9.9 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 $23,705TX $2,398
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.