How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,380 to $10,233Professionalmedian $1,380 · 10th to 90th $1,023 to $1,995
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,137.96 Typical High $2,818.38 | Professional | 50 · Both sides | $1,819.70 | $2,137.96 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,174.90 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $302.00 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $263.03 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $263.03 |
CDPHP Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $12,882.50 | Facility | None | $4,365.16 | $4,365.16 | $12,882.50 |
CDPHP Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,737.80 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,258.93 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $4,786.30 | Facility | None | $1,096.48 | $1,548.82 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,479.11 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,862.09 | Professional | None | $676.08 | $1,202.26 | $1,862.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,691.53 Typical High $6,760.83 | Facility | None | $1,047.13 | $2,691.53 | $6,760.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,202.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,000.00 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,230.27 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,137.96 | Professional | None | $912.01 | $1,380.38 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $3,311.31 | Facility | None | $1,318.26 | $1,380.38 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,862.09 | Professional | None | $676.08 | $1,202.26 | $1,862.09 |
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 $794.33 Median $794.33 Typical High $1,000.00 | Professional | 52 · Reduced service | $794.33 | $794.33 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 53 · Discontinued | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $954.99 Typical High $1,479.11 | Professional | 54 · Surgery only | $812.83 | $954.99 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $239.88 Typical High $371.54 | Professional | 55 · Aftercare only | $204.17 | $239.88 | $371.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $120.23 Typical High $186.21 | Professional | 56 · Pre-op care only | $102.33 | $120.23 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $707.95 | $851.14 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $891.25 Typical High $1,258.93 | Professional | 53 · Discontinued | $707.95 | $891.25 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,479.11 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $602.56 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $602.56 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $123.03 Typical High $302.00 | Professional | 56 · Pre-op care only | $102.33 | $123.03 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,318.26 |
Where New York sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
AK $10,675KY $2,688
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.