How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,349 to $14,454Professionalmedian $724 · 10th to 90th $589 to $1,202
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | None | $741.31 | $741.31 | $812.83 |
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 $602.56 Median $707.95 Typical High $977.24 | Professional | None | $602.56 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,047.13 Typical High $1,445.44 | Professional | 50 · Both sides | $891.25 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $446.68 Typical High $616.60 | Professional | 62 · Two surgeons | $380.19 | $446.68 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $154.88 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $134.90 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $134.90 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $8,317.64 Typical High $16,982.44 | Facility | None | $1,348.96 | $8,317.64 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,659.59 | Professional | None | $724.44 | $724.44 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $891.25 Typical High $2,818.38 | Facility | None | $776.25 | $891.25 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $977.24 | Professional | None | $416.87 | $645.65 | $977.24 |
MVP Health Care Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $776.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,862.09 | Professional | None | $758.58 | $1,122.02 | $1,862.09 |
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 $478.63 Median $741.31 Typical High $1,778.28 | Professional | None | $478.63 | $741.31 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $489.78 Median $676.08 Typical High $3,801.89 | Facility | None | $489.78 | $676.08 | $3,801.89 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $977.24 | Professional | None | $489.78 | $645.65 | $977.24 |
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 $371.54 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $758.58 | Professional | 54 · Surgery only | $331.13 | $501.19 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $134.90 Typical High $204.17 | Professional | 55 · Aftercare only | $89.13 | $134.90 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $64.57 Typical High $97.72 | Professional | 56 · Pre-op care only | $41.69 | $64.57 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $562.34 | Professional | 53 · Discontinued | $380.19 | $389.05 | $562.34 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $758.58 | Professional | 54 · Surgery only | $331.13 | $501.19 | $758.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $134.90 Typical High $398.11 | Professional | 55 · Aftercare only | $89.13 | $134.90 | $398.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $64.57 Typical High $190.55 | Professional | 56 · Pre-op care only | $41.69 | $64.57 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $676.08 |
Where New York sits
The same service costs 6.2 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 $14,513MT $2,350
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.