How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $9,333Professionalmedian $427 · 10th to 90th $355 to $724
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 $549.54 Median $4,897.79 Typical High $9,549.93 | Facility | None | $549.54 | $4,897.79 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
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 $354.81 Median $426.58 Typical High $588.84 | Professional | None | $354.81 | $426.58 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $630.96 Typical High $891.25 | Professional | 50 · Both sides | $537.03 | $630.96 | $891.25 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,348.96 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,000.00 | Professional | None | $416.87 | $416.87 | $1,000.00 |
Emblem Health Setting Facility Modifier None Typical Low $281.84 Median $489.78 Typical High $1,621.81 | Facility | None | $281.84 | $489.78 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $776.25 | Professional | None | $398.11 | $501.19 | $776.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $602.56 | Professional | None | $257.04 | $407.38 | $602.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $870.96 Median $3,090.30 Typical High $4,786.30 | Facility | None | $870.96 | $3,090.30 | $4,786.30 |
Highmark BCBS Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $489.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $912.01 | Professional | None | $389.05 | $389.05 | $912.01 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $7,413.10 | Facility | None | $1,148.15 | $2,511.89 | $7,413.10 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $1,047.13 | Professional | None | $295.12 | $446.68 | $1,047.13 |
Univera Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $1,318.26 | Facility | None | $302.00 | $398.11 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $602.56 | Professional | None | $302.00 | $398.11 | $602.56 |
10 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 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $338.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $501.19 | Professional | 54 · Surgery only | $204.17 | $316.23 | $501.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $85.11 Typical High $134.90 | Professional | 55 · Aftercare only | $53.70 | $85.11 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $40.74 Typical High $64.57 | Professional | 56 · Pre-op care only | $25.70 | $40.74 | $64.57 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $281.84 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $177.83 | $281.84 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $467.74 | Professional | 54 · Surgery only | $204.17 | $316.23 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $85.11 Typical High $239.88 | Professional | 55 · Aftercare only | $53.70 | $85.11 | $239.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $40.74 Typical High $114.82 | Professional | 56 · Pre-op care only | $25.70 | $40.74 | $114.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $177.83 | $281.84 | $407.38 |
Where New York sits
The same service costs 4.7 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 $6,797MT $1,449
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.