How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $14,454Professionalmedian $550 · 10th to 90th $398 to $933
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 $630.96 Median $4,786.30 Typical High $9,332.54 | Facility | None | $630.96 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $812.83 | Professional | None | $407.38 | $575.44 | $812.83 |
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 $467.74 Median $549.54 Typical High $741.31 | Professional | None | $467.74 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $112.20 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $77.62 Typical High $104.71 | Professional | AS · PA/NP assist | $64.57 | $77.62 | $104.71 |
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 $602.56 Median $602.56 Typical High $851.14 | Professional | None | $602.56 | $602.56 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $7,762.47 Typical High $15,848.93 | Facility | None | $1,318.26 | $7,762.47 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $1,258.93 | Professional | None | $389.05 | $549.54 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $1,659.59 | Facility | None | $436.52 | $524.81 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,096.48 | Professional | None | $524.81 | $602.56 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $758.58 | Professional | None | $331.13 | $575.44 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $446.68 Median $3,235.94 Typical High $4,365.16 | Facility | None | $446.68 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,479.11 | Professional | None | $524.81 | $524.81 | $1,479.11 |
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 $346.74 Median $537.03 Typical High $1,047.13 | Professional | None | $346.74 | $537.03 | $1,047.13 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $2,511.89 | Facility | None | $281.84 | $524.81 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $758.58 | Professional | None | $389.05 | $524.81 | $758.58 |
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 $288.40 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $114.82 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $57.54 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $426.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $457.09 Typical High $602.56 | Professional | 54 · Surgery only | $263.03 | $457.09 | $602.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $69.18 | $120.23 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $57.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.11 | $57.54 | $75.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $229.09 | $398.11 | $524.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $457.09 | Professional | 53 · Discontinued | $309.03 | $316.23 | $457.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $457.09 Typical High $602.56 | Professional | 54 · Surgery only | $263.03 | $457.09 | $602.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $120.23 Typical High $302.00 | Professional | 55 · Aftercare only | $69.18 | $120.23 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $57.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $33.11 | $57.54 | $144.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $229.09 | $398.11 | $524.81 |
Where New York sits
The same service costs 9.2 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 $13,499MT $1,470
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.