How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $14,454Professionalmedian $2,692 · 10th to 90th $1,820 to $3,388
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,187.76 | $2,344.23 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $15,488.17 | Facility | None | $1,862.09 | $8,709.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,884.03 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,819.70 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,548.82 | $1,819.70 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $457.09 Typical High $512.86 | Professional | 80 · Assistant surgeon | $389.05 | $457.09 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $398.11 Typical High $446.68 | Professional | AS · PA/NP assist | $338.84 | $398.11 | $446.68 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $4,677.35 | Professional | None | $1,778.28 | $1,819.70 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $2,187.76 Median $4,265.80 Typical High $7,585.78 | Facility | None | $2,187.76 | $4,265.80 | $7,585.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,187.76 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $3,235.94 | Professional | None | $912.01 | $1,698.24 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $1,905.46 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,905.46 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $5,011.87 | Professional | None | $1,995.26 | $2,754.23 | $5,011.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,606.93 | Facility | None | $575.44 | $1,737.80 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $5,495.41 | Professional | None | $1,174.90 | $2,344.23 | $5,495.41 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $8,511.38 | Facility | None | $1,071.52 | $1,819.70 | $8,511.38 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,071.52 | $1,698.24 | $3,235.94 |
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 $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,096.48 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,621.81 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,479.11 Typical High $2,818.38 | Professional | 54 · Surgery only | $794.33 | $1,479.11 | $2,818.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $218.78 Typical High $416.87 | Professional | 55 · Aftercare only | $117.49 | $218.78 | $416.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $186.21 Typical High $354.81 | Professional | 56 · Pre-op care only | $100.00 | $186.21 | $354.81 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,288.25 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $691.83 | $1,288.25 | $2,454.71 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $1,479.11 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,479.11 Typical High $2,818.38 | Professional | 54 · Surgery only | $794.33 | $1,479.11 | $2,818.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $218.78 Typical High $630.96 | Professional | 55 · Aftercare only | $117.49 | $218.78 | $630.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $186.21 Typical High $524.81 | Professional | 56 · Pre-op care only | $100.00 | $186.21 | $524.81 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,288.25 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $691.83 | $1,288.25 | $2,454.71 |
Where New York sits
The same service costs 14.0 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 $34,704TX $2,477
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.