How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,202 to $11,482Professionalmedian $490 · 10th to 90th $389 to $1,000
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 $1,348.96 Median $5,888.44 Typical High $11,748.98 | Facility | None | $1,348.96 | $5,888.44 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $1,380.38 | Professional | None | $407.38 | $549.54 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $851.14 | Professional | None | $416.87 | $489.78 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $309.03 Typical High $537.03 | Professional | 62 · Two surgeons | $263.03 | $309.03 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $77.62 Typical High $134.90 | Professional | 80 · Assistant surgeon | $66.07 | $77.62 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $69.18 Typical High $117.49 | Professional | AS · PA/NP assist | $57.54 | $69.18 | $117.49 |
CDPHP Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,659.59 | Professional | None | $446.68 | $575.44 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $1,737.80 | Facility | None | $478.63 | $831.76 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $851.14 | Professional | None | $478.63 | $524.81 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $660.69 | Professional | None | $309.03 | $398.11 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $467.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $467.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,148.15 | Professional | None | $645.65 | $1,000.00 | $1,148.15 |
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 $346.74 Median $575.44 Typical High $1,202.26 | Professional | None | $346.74 | $575.44 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $338.84 Median $426.58 Typical High $1,621.81 | Facility | None | $338.84 | $426.58 | $1,621.81 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $602.56 | Professional | None | $309.03 | $398.11 | $602.56 |
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 $204.17 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $302.00 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $60.26 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $281.84 | $380.19 | $380.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $338.84 Typical High $588.84 | Professional | 54 · Surgery only | $269.15 | $338.84 | $588.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $95.50 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $95.50 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $295.12 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $229.09 | $295.12 | $501.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $309.03 Typical High $467.74 | Professional | 53 · Discontinued | $234.42 | $309.03 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $562.34 | Professional | 54 · Surgery only | $269.15 | $346.74 | $562.34 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $125.89 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $48.98 Typical High $109.65 | Professional | 56 · Pre-op care only | $37.15 | $48.98 | $109.65 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $489.78 |
Where New York sits
The same service costs 17.8 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 $23,004TX $1,295
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.