How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,445 to $14,454Professionalmedian $1,122 · 10th to 90th $912 to $1,862
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 $2,238.72 Median $6,606.93 Typical High $14,791.08 | Facility | None | $2,238.72 | $6,606.93 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,174.90 | $1,288.25 |
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 $933.25 Median $1,096.48 Typical High $1,548.82 | Professional | None | $933.25 | $1,096.48 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $954.99 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $245.47 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $213.80 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $213.80 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,819.70 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,122.02 | $2,630.27 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $4,073.80 | Facility | None | $1,122.02 | $1,380.38 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,230.27 | $1,949.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,479.11 | Professional | None | $645.65 | $1,000.00 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $5,754.40 Typical High $23,442.29 | Facility | None | $1,202.26 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,698.24 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,754.23 | Professional | None | $741.31 | $1,174.90 | $2,754.23 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $4,466.84 | Facility | None | $758.58 | $1,047.13 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,479.11 | Professional | None | $758.58 | $1,000.00 | $1,479.11 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $512.86 | $776.25 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $208.93 Typical High $338.84 | Professional | 55 · Aftercare only | $134.90 | $208.93 | $338.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $158.49 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $891.25 | Professional | 53 · Discontinued | $588.84 | $602.56 | $891.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $776.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $512.86 | $776.25 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $208.93 Typical High $602.56 | Professional | 55 · Aftercare only | $134.90 | $208.93 | $602.56 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $288.40 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $1,047.13 |
Where New York sits
The same service costs 4.0 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 $14,467MT $3,639
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.