How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,479 to $14,454Professionalmedian $1,096 · 10th to 90th $891 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 $1,148.15 Median $1,148.15 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,148.15 | $2,187.76 |
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 $1,513.56 | Professional | None | $933.25 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $2,238.72 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $954.99 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $239.88 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $208.93 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $208.93 |
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 $1,096.48 Median $1,096.48 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,096.48 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $4,073.80 | Facility | None | $1,230.27 | $1,659.59 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,047.13 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,479.11 | Professional | None | $630.96 | $977.24 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,148.15 Median $5,754.40 Typical High $23,442.29 | Facility | None | $1,148.15 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,380.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $2,691.53 | Professional | None | $741.31 | $1,122.02 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $4,365.16 | Facility | None | $741.31 | $1,023.29 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,479.11 | Professional | None | $741.31 | $977.24 | $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 $575.44 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $575.44 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $501.19 | $776.25 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $331.13 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $158.49 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $870.96 | Professional | 53 · Discontinued | $575.44 | $588.84 | $870.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $776.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $501.19 | $776.25 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $588.84 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $588.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $281.84 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $1,023.29 |
Where New York sits
The same service costs 4.1 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 $14,431MT $3,557
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.