How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,349 to $14,125Professionalmedian $813 · 10th to 90th $661 to $1,380
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 $1,905.46 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,905.46 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,621.81 | Professional | None | $851.14 | $851.14 | $1,621.81 |
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 $676.08 Median $794.33 Typical High $1,096.48 | Professional | None | $676.08 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,202.26 Typical High $1,659.59 | Professional | 50 · Both sides | $1,000.00 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $691.83 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $691.83 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,348.96 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,862.09 | Professional | None | $812.83 | $812.83 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $3,019.95 | Facility | None | $691.83 | $933.25 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,412.54 | Professional | None | $758.58 | $912.01 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,071.52 | Professional | None | $467.74 | $724.44 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $5,754.40 Typical High $23,442.29 | Facility | None | $851.14 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $2,089.30 | Professional | None | $851.14 | $1,023.29 | $2,089.30 |
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 $549.54 Median $831.76 Typical High $1,995.26 | Professional | None | $549.54 | $831.76 | $1,995.26 |
Univera Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $3,235.94 | Facility | None | $549.54 | $758.58 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | None | $549.54 | $724.44 | $1,071.52 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $575.44 Typical High $912.01 | Professional | 54 · Surgery only | $371.54 | $575.44 | $912.01 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $151.36 Typical High $245.47 | Professional | 55 · Aftercare only | $97.72 | $151.36 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $72.44 Typical High $114.82 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $645.65 | Professional | 53 · Discontinued | $426.58 | $436.52 | $645.65 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $575.44 Typical High $851.14 | Professional | 54 · Surgery only | $371.54 | $575.44 | $851.14 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $151.36 Typical High $436.52 | Professional | 55 · Aftercare only | $97.72 | $151.36 | $436.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $72.44 Typical High $208.93 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $208.93 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $758.58 |
Where New York sits
The same service costs 5.3 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 $14,031MT $2,637
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.