How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $14,125Professionalmedian $741 · 10th to 90th $603 to $1,230
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 $870.96 Median $5,248.07 Typical High $10,471.29 | Facility | None | $870.96 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $2,089.30 | Professional | None | $758.58 | $758.58 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,000.00 | Professional | None | $630.96 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,122.02 Typical High $1,479.11 | Professional | 50 · Both sides | $954.99 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $467.74 Typical High $630.96 | Professional | 62 · Two surgeons | $398.11 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | 80 · Assistant surgeon | $100.00 | $120.23 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $138.04 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $138.04 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,348.96 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,570.40 | Professional | None | $724.44 | $724.44 | $2,570.40 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $2,754.23 | Facility | None | $489.78 | $831.76 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,258.93 | Professional | None | $676.08 | $831.76 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $977.24 | Professional | None | $426.58 | $676.08 | $977.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $10,471.29 | Facility | None | $831.76 | $3,801.89 | $10,471.29 |
Highmark BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,380.38 | Professional | None | $707.95 | $1,071.52 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $5,754.40 | Facility | None | $758.58 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,862.09 | Professional | None | $776.25 | $954.99 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,905.46 | Professional | None | $501.19 | $758.58 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $676.08 Typical High $3,548.13 | Facility | None | $501.19 | $676.08 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $977.24 | Professional | None | $501.19 | $676.08 | $977.24 |
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 $380.19 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 54 · Surgery only | $575.44 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $549.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $338.84 | $524.81 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $208.93 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $67.61 Typical High $100.00 | Professional | 56 · Pre-op care only | $42.66 | $67.61 | $100.00 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $457.09 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $295.12 | $457.09 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $575.44 | Professional | 53 · Discontinued | $389.05 | $398.11 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $338.84 | $524.81 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $398.11 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $398.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $67.61 Typical High $190.55 | Professional | 56 · Pre-op care only | $42.66 | $67.61 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $457.09 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $295.12 | $457.09 | $676.08 |
Where New York sits
The same service costs 5.7 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 $13,613MT $2,377
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.