How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,230 to $23,442Professionalmedian $295 · 10th to 90th $245 to $537
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 $1,513.56 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,513.56 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $416.87 | Professional | None | $245.47 | $288.40 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $45.71 Typical High $66.07 | Professional | 80 · Assistant surgeon | $38.90 | $45.71 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $39.81 Typical High $57.54 | Professional | AS · PA/NP assist | $33.88 | $39.81 | $57.54 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $21,877.62 Typical High $44,668.36 | Facility | None | $954.99 | $21,877.62 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $741.31 | Professional | None | $288.40 | $288.40 | $741.31 |
Emblem Health Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $1,318.26 | Facility | None | $338.84 | $602.56 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $575.44 | Professional | None | $295.12 | $380.19 | $575.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $407.38 | Professional | None | $239.88 | $295.12 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $4,365.16 Typical High $48,977.88 | Facility | None | $309.03 | $4,365.16 | $48,977.88 |
MVP Health Care Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $794.33 | Professional | None | $323.59 | $338.84 | $794.33 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $4,786.30 Typical High $28,840.32 | Facility | None | $1,412.54 | $4,786.30 | $28,840.32 |
United Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $851.14 | Professional | None | $204.17 | $380.19 | $851.14 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $295.12 Typical High $1,148.15 | Facility | None | $281.84 | $295.12 | $1,148.15 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $407.38 | Professional | None | $239.88 | $295.12 | $407.38 |
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 $177.83 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $251.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $208.93 | $257.04 | $354.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $52.48 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $309.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $269.15 | Professional | 53 · Discontinued | $162.18 | $169.82 | $269.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $208.93 | $257.04 | $354.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $102.33 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $102.33 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $87.10 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $87.10 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $309.03 |
Where New York sits
The same service costs 29.1 times more in Alabama than in Montana. 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
AL $30,626MT $1,051
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.