How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $14,125Professionalmedian $417 · 10th to 90th $339 to $708
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 $436.52 Median $446.68 Typical High $489.78 | Professional | None | $436.52 | $446.68 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $575.44 | Professional | None | $338.84 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $91.20 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $81.28 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $81.28 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,318.26 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,000.00 | Professional | None | $426.58 | $426.58 | $1,000.00 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,778.28 | Facility | None | $467.74 | $645.65 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $776.25 | Professional | None | $398.11 | $426.58 | $776.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $562.34 | Professional | None | $245.47 | $398.11 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $4,365.16 | Facility | None | $436.52 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $1,000.00 | Professional | None | $446.68 | $467.74 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $1,047.13 | Professional | None | $309.03 | $457.09 | $1,047.13 |
Univera Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $2,398.83 | Facility | None | $288.40 | $398.11 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $562.34 | Professional | None | $288.40 | $398.11 | $562.34 |
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 $218.78 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $309.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $218.78 | $354.81 | $537.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $24.55 | $39.81 | $60.26 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $39.81 Typical High $60.26 | Professional | 56 · Pre-op care only | $24.55 | $39.81 | $60.26 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $194.98 | $316.23 | $478.63 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $346.74 | Professional | 53 · Discontinued | $223.87 | $223.87 | $346.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $354.81 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $354.81 | $501.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $39.81 Typical High $107.15 | Professional | 55 · Aftercare only | $24.55 | $39.81 | $107.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $39.81 Typical High $107.15 | Professional | 56 · Pre-op care only | $24.55 | $39.81 | $107.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $316.23 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $194.98 | $316.23 | $446.68 |
Where New York sits
The same service costs 8.5 times more in Colorado 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
CO $11,809MT $1,385
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.