How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,514 to $16,218Professionalmedian $1,288 · 10th to 90th $1,047 to $2,951
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 $13,803.84 | Facility | None | $1,819.70 | $6,456.54 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $4,265.80 | Professional | None | $1,479.11 | $1,621.81 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $17,378.01 | Facility | None | $1,862.09 | $8,709.64 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,258.93 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,621.81 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $407.38 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $354.81 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $354.81 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,202.26 Median $1,513.56 Typical High $7,079.46 | Professional | None | $1,202.26 | $1,513.56 | $7,079.46 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,445.44 | $2,951.21 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,548.82 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,659.59 | Professional | None | $954.99 | $1,122.02 | $1,659.59 |
MVP Health Care Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $87,096.36 | Facility | None | $1,348.96 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,819.70 | $1,819.70 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $4,073.80 | Professional | None | $1,023.29 | $1,698.24 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $5,754.40 | Facility | None | $1,148.15 | $1,230.27 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,659.59 | Professional | None | $954.99 | $1,122.02 | $1,659.59 |
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 $741.31 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,548.82 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $144.54 Typical High $229.09 | Professional | 55 · Aftercare only | $123.03 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $194.98 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $1,348.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $891.25 Typical High $1,318.26 | Professional | 53 · Discontinued | $660.69 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,445.44 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,445.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $144.54 Typical High $331.13 | Professional | 55 · Aftercare only | $123.03 | $144.54 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $275.42 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $1,258.93 |
Where New York sits
The same service costs 13.5 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 $34,179TX $2,531
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.