How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $10,233Professionalmedian $912 · 10th to 90th $741 to $1,660
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 $11,748.98 | Facility | None | $1,819.70 | $6,456.54 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,122.02 | $1,949.84 |
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 $758.58 Median $891.25 Typical High $1,318.26 | Professional | None | $758.58 | $891.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $812.83 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $204.17 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $177.83 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $177.83 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $870.96 Median $891.25 Typical High $2,238.72 | Professional | None | $870.96 | $891.25 | $2,238.72 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $3,890.45 | Facility | None | $1,023.29 | $1,862.09 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,737.80 | Professional | None | $891.25 | $1,122.02 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,096.48 | Professional | None | $724.44 | $870.96 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $5,754.40 Typical High $48,977.88 | Facility | None | $912.01 | $5,754.40 | $48,977.88 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,398.83 | Professional | None | $977.24 | $1,148.15 | $2,398.83 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,606.93 | Facility | None | $575.44 | $1,778.28 | $6,606.93 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,630.27 | Professional | None | $602.56 | $1,122.02 | $2,630.27 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $3,630.78 | Facility | None | $851.14 | $891.25 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,096.48 | Professional | None | $724.44 | $870.96 | $1,096.48 |
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 $524.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $794.33 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $1,047.13 | Professional | 54 · Surgery only | $630.96 | $758.58 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $158.49 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $158.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $95.50 Typical High $131.83 | Professional | 56 · Pre-op care only | $79.43 | $95.50 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $758.58 | Professional | 53 · Discontinued | $478.63 | $478.63 | $758.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | 54 · Surgery only | $630.96 | $758.58 | $954.99 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $309.03 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $95.50 Typical High $263.03 | Professional | 56 · Pre-op care only | $79.43 | $95.50 | $263.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $891.25 |
Where New York sits
The same service costs 10.7 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 $15,939TX $1,488
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.