How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,259 to $15,849Professionalmedian $832 · 10th to 90th $646 to $1,905
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 $851.14 Median $5,370.32 Typical High $12,302.69 | Facility | None | $851.14 | $5,370.32 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $2,137.96 | Professional | None | $741.31 | $912.01 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $7,079.46 Typical High $19,498.45 | Facility | None | $1,778.28 | $7,079.46 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,445.44 | Professional | None | $707.95 | $831.76 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $229.09 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $114.82 Typical High $199.53 | Professional | AS · PA/NP assist | $97.72 | $114.82 | $199.53 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $5,128.61 Typical High $10,232.93 | Facility | None | $1,445.44 | $5,128.61 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $3,019.95 | Professional | None | $933.25 | $1,000.00 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $851.14 Median $2,344.23 Typical High $3,890.45 | Facility | None | $851.14 | $2,344.23 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,479.11 | Professional | None | $794.33 | $912.01 | $1,479.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,000.00 | Professional | None | $436.52 | $645.65 | $1,000.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $7,943.28 Typical High $15,488.17 | Facility | None | $6,309.57 | $7,943.28 | $15,488.17 |
MVP Health Care Setting Facility Modifier None Typical Low $794.33 Median $6,456.54 Typical High $7,079.46 | Facility | None | $794.33 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,905.46 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $17,782.79 | Facility | None | $1,318.26 | $4,073.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $2,041.74 | Professional | None | $602.56 | $933.25 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $660.69 Median $724.44 Typical High $2,630.27 | Facility | None | $660.69 | $724.44 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $933.25 | Professional | None | $436.52 | $645.65 | $933.25 |
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 $371.54 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $74.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 54 · Surgery only | $426.58 | $501.19 | $794.33 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $239.88 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $109.65 Typical High $177.83 | Professional | 56 · Pre-op care only | $93.33 | $109.65 | $177.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $630.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $524.81 Typical High $776.25 | Professional | 53 · Discontinued | $389.05 | $524.81 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $426.58 | $501.19 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $346.74 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $109.65 Typical High $257.04 | Professional | 56 · Pre-op care only | $93.33 | $109.65 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $724.44 |
Where New York sits
The same service costs 4.9 times more in Wisconsin 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
WI $11,639MT $2,377
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.