How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $9,333Professionalmedian $457 · 10th to 90th $316 to $741
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 $1,348.96 Median $4,786.30 Typical High $8,317.64 | Facility | None | $1,348.96 | $4,786.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $512.86 | Professional | None | $323.59 | $478.63 | $512.86 |
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 $407.38 Median $489.78 Typical High $616.60 | Professional | None | $407.38 | $489.78 | $616.60 |
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 $457.09 Median $457.09 Typical High $691.83 | Professional | None | $457.09 | $457.09 | $691.83 |
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 $302.00 Median $457.09 Typical High $1,023.29 | Professional | None | $302.00 | $457.09 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $1,288.25 | Facility | None | $338.84 | $562.34 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $912.01 | Professional | None | $436.52 | $501.19 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $630.96 | Professional | None | $275.42 | $478.63 | $630.96 |
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 $426.58 Median $426.58 Typical High $1,230.27 | Professional | None | $426.58 | $426.58 | $1,230.27 |
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 $269.15 Median $426.58 Typical High $870.96 | Professional | None | $269.15 | $426.58 | $870.96 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $436.52 Typical High $1,445.44 | Facility | None | $223.87 | $436.52 | $1,445.44 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $630.96 | Professional | None | $323.59 | $436.52 | $630.96 |
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 $162.18 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $331.13 | $346.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $371.54 Typical High $501.19 | Professional | 54 · Surgery only | $213.80 | $371.54 | $501.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $57.54 | $100.00 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $47.86 Typical High $63.10 | Professional | 56 · Pre-op care only | $27.54 | $47.86 | $63.10 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $323.59 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $190.55 | $323.59 | $436.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $380.19 | Professional | 53 · Discontinued | $251.19 | $263.03 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $371.54 Typical High $501.19 | Professional | 54 · Surgery only | $213.80 | $371.54 | $501.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $100.00 Typical High $245.47 | Professional | 55 · Aftercare only | $57.54 | $100.00 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $47.86 Typical High $117.49 | Professional | 56 · Pre-op care only | $27.54 | $47.86 | $117.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $323.59 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $190.55 | $323.59 | $436.52 |
Where New York sits
The same service costs 5.3 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 $6,378MT $1,213
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.