How much rates vary
Facilitymedian $2,818 · 10th to 90th $617 to $7,079Professionalmedian $550 · 10th to 90th $447 to $1,000
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 $549.54 Median $1,995.26 Typical High $7,943.28 | Facility | None | $549.54 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,023.29 | Professional | None | $524.81 | $549.54 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $741.31 | Professional | None | $467.74 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $831.76 Typical High $1,071.52 | Professional | 50 · Both sides | $707.95 | $831.76 | $1,071.52 |
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 $724.44 Median $724.44 Typical High $776.25 | Professional | None | $724.44 | $724.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $3,019.95 | Facility | None | $1,047.13 | $1,819.70 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,202.26 | Professional | None | $501.19 | $537.03 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $2,137.96 | Facility | None | $524.81 | $676.08 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,148.15 | Professional | None | $501.19 | $758.58 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $724.44 | Professional | None | $316.23 | $549.54 | $724.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,981.07 | Facility | None | $1,778.28 | $2,454.71 | $3,981.07 |
Highmark BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,445.44 | Professional | None | $645.65 | $758.58 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $575.44 Median $3,235.94 Typical High $4,365.16 | Facility | None | $575.44 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,380.38 | Professional | None | $501.19 | $501.19 | $1,380.38 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,258.93 | Professional | None | $398.11 | $562.34 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $2,041.74 | Facility | None | $346.74 | $501.19 | $2,041.74 |
Univera Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $724.44 | Professional | None | $371.54 | $512.86 | $724.44 |
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 $263.03 Median $275.42 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $398.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $426.58 Typical High $616.60 | Professional | 54 · Surgery only | $251.19 | $426.58 | $616.60 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $114.82 Typical High $162.18 | Professional | 55 · Aftercare only | $66.07 | $114.82 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $31.62 | $54.95 | $77.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $380.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $218.78 | $380.19 | $537.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $416.87 | Professional | 53 · Discontinued | $281.84 | $288.40 | $416.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $251.19 | $467.74 | $575.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $125.89 Typical High $281.84 | Professional | 55 · Aftercare only | $66.07 | $125.89 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $60.26 Typical High $134.90 | Professional | 56 · Pre-op care only | $31.62 | $60.26 | $134.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $407.38 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $218.78 | $407.38 | $501.19 |
Where New York sits
The same service costs 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.