How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $7,413Professionalmedian $309 · 10th to 90th $245 to $537
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 $1,659.59 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,659.59 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $645.65 | Professional | None | $316.23 | $316.23 | $645.65 |
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 $251.19 Median $295.12 Typical High $416.87 | Professional | None | $251.19 | $295.12 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $446.68 Typical High $630.96 | Professional | 50 · Both sides | $371.54 | $446.68 | $630.96 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $3,019.95 | Facility | None | $1,023.29 | $1,584.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $707.95 | Professional | None | $309.03 | $309.03 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $436.52 Typical High $1,288.25 | Facility | None | $354.81 | $436.52 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $562.34 | Professional | None | $295.12 | $371.54 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $436.52 | Professional | None | $186.21 | $295.12 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $302.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $302.00 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $812.83 | Professional | None | $331.13 | $380.19 | $812.83 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $6,309.57 | Facility | None | $812.83 | $2,187.76 | $6,309.57 |
United Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $794.33 | Professional | None | $218.78 | $331.13 | $794.33 |
Univera Setting Facility Modifier None Typical Low $218.78 Median $295.12 Typical High $1,949.84 | Facility | None | $218.78 | $295.12 | $1,949.84 |
Univera Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $436.52 | Professional | None | $218.78 | $295.12 | $436.52 |
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 $158.49 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $63.10 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $234.42 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $363.08 | Professional | 54 · Surgery only | $147.91 | $234.42 | $363.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $63.10 Typical High $97.72 | Professional | 55 · Aftercare only | $39.81 | $63.10 | $97.72 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $46.77 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $46.77 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $323.59 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $245.47 | Professional | 53 · Discontinued | $165.96 | $169.82 | $245.47 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $338.84 | Professional | 54 · Surgery only | $147.91 | $234.42 | $338.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $63.10 Typical High $173.78 | Professional | 55 · Aftercare only | $39.81 | $63.10 | $173.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $83.18 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $83.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $302.00 |
Where New York sits
The same service costs 4.6 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 $4,822MT $1,050
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.