How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $7,413Professionalmedian $525 · 10th to 90th $331 to $851
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 $407.38 Median $3,548.13 Typical High $8,128.31 | Facility | None | $407.38 | $3,548.13 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $660.69 | Professional | None | $338.84 | $512.86 | $660.69 |
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 $676.08 | Professional | None | $467.74 | $549.54 | $676.08 |
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 $467.74 Median $467.74 Typical High $794.33 | Professional | None | $467.74 | $467.74 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $2,570.40 | Facility | None | $912.01 | $1,584.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $1,202.26 | Professional | None | $323.59 | $537.03 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $371.54 Typical High $1,258.93 | Facility | None | $204.17 | $371.54 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,071.52 | Professional | None | $512.86 | $707.95 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $707.95 | Professional | None | $309.03 | $549.54 | $707.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $676.08 Median $977.24 Typical High $3,019.95 | Facility | None | $676.08 | $977.24 | $3,019.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $1,000.00 | Professional | None | $457.09 | $467.74 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $371.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $371.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $1,348.96 | Professional | None | $288.40 | $288.40 | $1,348.96 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $933.25 | Professional | None | $275.42 | $457.09 | $933.25 |
Univera Setting Facility Modifier None Typical Low $229.09 Median $512.86 Typical High $1,318.26 | Facility | None | $229.09 | $512.86 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $707.95 | Professional | None | $363.08 | $537.03 | $707.95 |
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 $169.82 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $67.61 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $257.04 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $77.62 Typical High $87.10 | Professional | 55 · Aftercare only | $51.29 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.88 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $239.88 | $354.81 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $426.58 | $562.34 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $112.20 Typical High $151.36 | Professional | 55 · Aftercare only | $64.57 | $112.20 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $30.90 | $53.70 | $70.79 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $371.54 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $213.80 | $371.54 | $489.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $407.38 | Professional | 53 · Discontinued | $275.42 | $281.84 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $426.58 | $562.34 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $112.20 Typical High $281.84 | Professional | 55 · Aftercare only | $64.57 | $112.20 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $53.70 Typical High $131.83 | Professional | 56 · Pre-op care only | $30.90 | $53.70 | $131.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $371.54 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $213.80 | $371.54 | $512.86 |
Where New York sits
The same service costs 4.4 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 $4,828WV $1,100
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.