How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $9,333Professionalmedian $550 · 10th to 90th $363 to $891
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $645.65 | Professional | None | $407.38 | $549.54 | $645.65 |
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 $501.19 Median $588.84 Typical High $724.44 | Professional | None | $501.19 | $588.84 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | 50 · Both sides | $741.31 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $93.33 Typical High $114.82 | Professional | 80 · Assistant surgeon | $79.43 | $93.33 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $83.18 Typical High $100.00 | Professional | AS · PA/NP assist | $69.18 | $83.18 | $100.00 |
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 $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,148.15 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $1,122.02 | Professional | None | $338.84 | $524.81 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $1,348.96 | Facility | None | $380.19 | $660.69 | $1,348.96 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $954.99 | Professional | None | $501.19 | $537.03 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $676.08 | Professional | None | $295.12 | $512.86 | $676.08 |
MVP Health Care Setting Facility Modifier None Typical Low $363.08 Median $3,235.94 Typical High $4,365.16 | Facility | None | $363.08 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,445.44 | Professional | None | $457.09 | $457.09 | $1,445.44 |
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 $295.12 Median $524.81 Typical High $1,122.02 | Professional | None | $295.12 | $524.81 | $1,122.02 |
Univera Setting Facility Modifier None Typical Low $229.09 Median $501.19 Typical High $1,348.96 | Facility | None | $229.09 | $501.19 | $1,348.96 |
Univera Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $676.08 | Professional | None | $346.74 | $501.19 | $676.08 |
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 $204.17 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $81.28 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $309.03 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $234.42 | $398.11 | $575.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $61.66 | $107.15 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $51.29 Typical High $72.44 | Professional | 56 · Pre-op care only | $29.51 | $51.29 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $204.17 | $346.74 | $501.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | 53 · Discontinued | $331.13 | $331.13 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $234.42 | $398.11 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $107.15 Typical High $245.47 | Professional | 55 · Aftercare only | $61.66 | $107.15 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $51.29 Typical High $117.49 | Professional | 56 · Pre-op care only | $29.51 | $51.29 | $117.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $204.17 | $346.74 | $501.19 |
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 $6,451MT $1,460
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.