How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,318 to $14,454Professionalmedian $661 · 10th to 90th $537 to $1,122
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 $691.83 Median $691.83 Typical High $1,348.96 | Professional | None | $691.83 | $691.83 | $1,348.96 |
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 $549.54 Median $645.65 Typical High $891.25 | Professional | None | $549.54 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $977.24 Typical High $1,348.96 | Professional | 50 · Both sides | $831.76 | $977.24 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $407.38 Typical High $616.60 | Professional | 62 · Two surgeons | $346.74 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $144.54 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $125.89 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $125.89 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $8,317.64 Typical High $16,982.44 | Facility | None | $1,318.26 | $8,317.64 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,548.82 | Professional | None | $660.69 | $660.69 | $1,548.82 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $891.25 Typical High $2,691.53 | Facility | None | $691.83 | $891.25 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,174.90 | Professional | None | $616.60 | $758.58 | $1,174.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $891.25 | Professional | None | $389.05 | $602.56 | $891.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $5,754.40 | Facility | None | $676.08 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,698.24 | Professional | None | $707.95 | $851.14 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,659.59 | Professional | None | $457.09 | $691.83 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $457.09 Median $616.60 Typical High $2,691.53 | Facility | None | $457.09 | $616.60 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $891.25 | Professional | None | $457.09 | $602.56 | $891.25 |
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 $346.74 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $478.63 Typical High $758.58 | Professional | 54 · Surgery only | $309.03 | $478.63 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $204.17 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $60.26 Typical High $95.50 | Professional | 56 · Pre-op care only | $38.90 | $60.26 | $95.50 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $416.87 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $416.87 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $524.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $524.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $309.03 | $478.63 | $707.95 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $363.08 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $363.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $60.26 Typical High $173.78 | Professional | 56 · Pre-op care only | $38.90 | $60.26 | $173.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $269.15 | $416.87 | $616.60 |
Where New York sits
The same service costs 7.4 times more in Colorado than in West Virginia. 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 $14,116WV $1,898
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.