How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $11,220Professionalmedian $1,096 · 10th to 90th $891 to $2,291
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,258.93 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,137.96 | Professional | None | $912.01 | $1,071.52 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $676.08 Typical High $1,348.96 | Professional | 62 · Two surgeons | $575.44 | $676.08 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $338.84 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $295.12 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $295.12 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $933.25 Median $1,445.44 Typical High $4,265.80 | Professional | None | $933.25 | $1,445.44 | $4,265.80 |
Emblem Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $4,265.80 | Facility | None | $1,318.26 | $1,862.09 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,380.38 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,380.38 | Professional | None | $741.31 | $1,047.13 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,202.26 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,778.28 | $2,884.03 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $3,090.30 | Professional | None | $870.96 | $1,412.54 | $3,090.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $4,365.16 | Facility | None | $575.44 | $1,047.13 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,380.38 | Professional | None | $741.31 | $1,047.13 | $1,380.38 |
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 $630.96 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $251.19 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $933.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $676.08 | $933.25 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $134.90 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $831.76 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $616.60 | $831.76 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $776.25 Typical High $1,122.02 | Professional | 53 · Discontinued | $562.34 | $776.25 | $1,122.02 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $933.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $676.08 | $933.25 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $194.98 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $194.98 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $831.76 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $616.60 | $831.76 | $1,148.15 |
Where New York sits
The same service costs 15.4 times more in Maine than in Maryland. 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 $28,500MD $1,851
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.