How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,349 to $14,454Professionalmedian $832 · 10th to 90th $676 to $1,413
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 $1,819.70 Median $5,370.32 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,370.32 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,659.59 | Professional | None | $851.14 | $851.14 | $1,659.59 |
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 $691.83 Median $812.83 Typical High $1,122.02 | Professional | None | $691.83 | $812.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $1,659.59 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $707.95 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $97.72 | $114.82 | $154.88 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,412.54 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,949.84 | Professional | None | $831.76 | $831.76 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,288.25 Typical High $3,388.44 | Facility | None | $977.24 | $1,288.25 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,479.11 | Professional | None | $794.33 | $977.24 | $1,479.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,122.02 | Professional | None | $489.78 | $776.25 | $1,122.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $13,803.84 | Facility | None | $13,803.84 | $13,803.84 | $13,803.84 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $5,754.40 | Facility | None | $851.14 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $2,137.96 | Professional | None | $891.25 | $1,023.29 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $2,089.30 | Professional | None | $575.44 | $891.25 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $3,467.37 | Facility | None | $575.44 | $794.33 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Professional | None | $575.44 | $776.25 | $1,122.02 |
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 $426.58 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $616.60 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $234.42 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $112.20 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $457.09 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $616.60 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $467.74 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $223.87 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $794.33 |
Where New York sits
The same service costs 5.7 times more in Colorado than in Hawaii. 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 $14,385HI $2,542
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.