How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,096 to $9,550Professionalmedian $331 · 10th to 90th $269 to $562
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 $1,698.24 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,698.24 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $676.08 | Professional | None | $354.81 | $363.08 | $676.08 |
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 $275.42 Median $323.59 Typical High $457.09 | Professional | None | $275.42 | $323.59 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $478.63 Typical High $676.08 | Professional | 50 · Both sides | $407.38 | $478.63 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $51.29 Typical High $72.44 | Professional | 80 · Assistant surgeon | $43.65 | $51.29 | $72.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $44.67 Typical High $60.26 | Professional | AS · PA/NP assist | $38.02 | $44.67 | $60.26 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $758.58 | Professional | None | $316.23 | $316.23 | $758.58 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $407.38 Typical High $1,258.93 | Facility | None | $302.00 | $407.38 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $588.84 | Professional | None | $302.00 | $389.05 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $457.09 | Professional | None | $199.53 | $309.03 | $457.09 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $3,235.94 Typical High $4,365.16 | Facility | None | $398.11 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $851.14 | Professional | None | $354.81 | $371.54 | $851.14 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $794.33 | Professional | None | $229.09 | $346.74 | $794.33 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $302.00 Typical High $1,862.09 | Facility | None | $234.42 | $302.00 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $457.09 | Professional | None | $234.42 | $309.03 | $457.09 |
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 $177.83 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $269.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $389.05 | Professional | 54 · Surgery only | $158.49 | $245.47 | $389.05 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $104.71 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $104.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $19.95 | $30.90 | $48.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $213.80 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $138.04 | $213.80 | $338.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $263.03 | Professional | 53 · Discontinued | $177.83 | $181.97 | $263.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $363.08 | Professional | 54 · Surgery only | $158.49 | $245.47 | $363.08 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $186.21 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $186.21 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.90 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.95 | $30.90 | $89.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $213.80 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $138.04 | $213.80 | $316.23 |
Where New York sits
The same service costs 6.0 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 $6,645MT $1,112
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.