How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,445 to $14,125Professionalmedian $977 · 10th to 90th $776 to $1,698
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 $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,000.00 | $1,122.02 |
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 $776.25 Median $912.01 Typical High $1,380.38 | Professional | None | $776.25 | $912.01 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,380.38 Typical High $2,041.74 | Professional | 50 · Both sides | $1,174.90 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $870.96 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $218.78 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $190.55 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $190.55 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,737.80 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,047.13 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $3,890.45 | Facility | None | $1,096.48 | $1,584.89 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,819.70 | Professional | None | $977.24 | $1,202.26 | $1,819.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,380.38 | Professional | None | $602.56 | $954.99 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,023.29 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,584.89 | $2,630.27 |
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 $724.44 Median $1,071.52 Typical High $2,511.89 | Professional | None | $724.44 | $1,071.52 | $2,511.89 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $977.24 Typical High $5,370.32 | Facility | None | $707.95 | $977.24 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,380.38 | Professional | None | $707.95 | $954.99 | $1,380.38 |
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 $501.19 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $776.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $1,174.90 | Professional | 54 · Surgery only | $478.63 | $758.58 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $199.53 Typical High $316.23 | Professional | 55 · Aftercare only | $125.89 | $199.53 | $316.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $95.50 Typical High $147.91 | Professional | 56 · Pre-op care only | $60.26 | $95.50 | $147.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $660.69 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $416.87 | $660.69 | $1,023.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $549.54 Typical High $794.33 | Professional | 53 · Discontinued | $537.03 | $549.54 | $794.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $1,096.48 | Professional | 54 · Surgery only | $478.63 | $758.58 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $199.53 Typical High $562.34 | Professional | 55 · Aftercare only | $125.89 | $199.53 | $562.34 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $95.50 Typical High $269.15 | Professional | 56 · Pre-op care only | $60.26 | $95.50 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $660.69 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $416.87 | $660.69 | $977.24 |
Where New York sits
The same service costs 5.1 times more in Colorado than in Hawaii. 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 $14,362HI $2,794
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.