How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,096 to $10,000Professionalmedian $1,230 · 10th to 90th $1,000 to $2,754
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,584.89 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,202.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,548.82 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $389.05 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $338.84 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,174.90 Median $1,479.11 Typical High $6,760.83 | Professional | None | $1,174.90 | $1,479.11 | $6,760.83 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $4,897.79 | Facility | None | $1,348.96 | $2,187.76 | $4,897.79 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,621.81 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $933.25 | $1,122.02 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,258.93 Median $4,786.30 Typical High $87,096.36 | Facility | None | $1,258.93 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,659.59 | $1,659.59 | $3,311.31 |
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 $1,071.52 Median $1,659.59 Typical High $3,981.07 | Professional | None | $1,071.52 | $1,659.59 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $5,248.07 | Facility | None | $1,096.48 | $1,202.26 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $933.25 | $1,122.02 | $1,584.89 |
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 $691.83 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $1,479.11 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $218.78 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $218.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $186.21 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $851.14 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $707.95 | $851.14 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $851.14 Typical High $1,230.27 | Professional | 53 · Discontinued | $616.60 | $851.14 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $1,380.38 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $316.23 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $316.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $263.03 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $263.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $851.14 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $707.95 | $851.14 | $1,202.26 |
Where New York sits
The same service costs 8.5 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 $16,489MD $1,943
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.