How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,230 to $10,000Professionalmedian $871 · 10th to 90th $692 to $1,318
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,096.48 | $1,230.27 |
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 $724.44 Median $851.14 Typical High $1,202.26 | Professional | None | $724.44 | $851.14 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,819.70 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $758.58 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $194.98 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $169.82 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $169.82 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,348.96 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $2,041.74 | Professional | None | $724.44 | $758.58 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $3,162.28 | Facility | None | $891.25 | $1,071.52 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,412.54 | Professional | None | $794.33 | $912.01 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,202.26 | Professional | None | $489.78 | $741.31 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,258.93 | $1,288.25 |
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 $602.56 Median $933.25 Typical High $1,412.54 | Professional | None | $602.56 | $933.25 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $794.33 Median $870.96 Typical High $3,548.13 | Facility | None | $794.33 | $870.96 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,202.26 | Professional | None | $489.78 | $741.31 | $1,202.26 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $977.24 | Professional | 54 · Surgery only | $512.86 | $602.56 | $977.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $239.88 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $120.23 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $120.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $851.14 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $588.84 Typical High $812.83 | Professional | 53 · Discontinued | $467.74 | $588.84 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $977.24 | Professional | 54 · Surgery only | $512.86 | $630.96 | $977.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $158.49 Typical High $354.81 | Professional | 55 · Aftercare only | $125.89 | $158.49 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $79.43 Typical High $177.83 | Professional | 56 · Pre-op care only | $63.10 | $79.43 | $177.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $851.14 |
Where New York sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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
WI $8,254FL $2,626
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.