How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $9,333Professionalmedian $490 · 10th to 90th $389 to $776
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 $588.84 Median $4,786.30 Typical High $9,549.93 | Facility | None | $588.84 | $4,786.30 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | None | $489.78 | $489.78 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $630.96 | Professional | None | $416.87 | $489.78 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $741.31 Typical High $954.99 | Professional | 50 · Both sides | $630.96 | $741.31 | $954.99 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $4,265.80 | Facility | None | $1,513.56 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,071.52 | Professional | None | $478.63 | $478.63 | $1,071.52 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $1,778.28 | Facility | None | $295.12 | $512.86 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $831.76 | Professional | None | $436.52 | $537.03 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $616.60 | Professional | None | $269.15 | $426.58 | $616.60 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $5,888.44 | Facility | None | $1,659.59 | $3,981.07 | $5,888.44 |
MVP Health Care Setting Facility Modifier None Typical Low $512.86 Median $3,235.94 Typical High $4,365.16 | Facility | None | $512.86 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,023.29 | Professional | None | $407.38 | $407.38 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,148.15 | Professional | None | $331.13 | $489.78 | $1,148.15 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $436.52 Typical High $1,318.26 | Facility | None | $316.23 | $436.52 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $616.60 | Professional | None | $316.23 | $426.58 | $616.60 |
10 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 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $346.74 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $338.84 | $346.74 | $354.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $338.84 Typical High $489.78 | Professional | 54 · Surgery only | $208.93 | $338.84 | $489.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $89.13 Typical High $128.82 | Professional | 55 · Aftercare only | $56.23 | $89.13 | $128.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $42.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $26.92 | $42.66 | $61.66 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $295.12 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $181.97 | $295.12 | $426.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $338.84 Typical High $489.78 | Professional | 54 · Surgery only | $208.93 | $338.84 | $489.78 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $89.13 Typical High $257.04 | Professional | 55 · Aftercare only | $56.23 | $89.13 | $257.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $42.66 Typical High $123.03 | Professional | 56 · Pre-op care only | $26.92 | $42.66 | $123.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $295.12 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $181.97 | $295.12 | $436.52 |
Where New York sits
The same service costs 4.4 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 $6,812MT $1,536
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.