How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,318 to $14,125Professionalmedian $537 · 10th to 90th $437 to $891
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 $5,623.41 Typical High $10,471.29 | Facility | None | $1,819.70 | $5,623.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $588.84 | Professional | None | $549.54 | $549.54 | $588.84 |
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 $446.68 Median $524.81 Typical High $724.44 | Professional | None | $446.68 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $776.25 Typical High $1,096.48 | Professional | 50 · Both sides | $660.69 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $83.18 Typical High $117.49 | Professional | 80 · Assistant surgeon | $70.79 | $83.18 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $102.33 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $102.33 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,621.81 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,230.27 | Professional | None | $537.03 | $537.03 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $2,137.96 | Facility | None | $616.60 | $812.83 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $933.25 | Professional | None | $501.19 | $616.60 | $933.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $724.44 | Professional | None | $309.03 | $489.78 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $4,365.16 | Facility | None | $741.31 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,380.38 | Professional | None | $562.34 | $851.14 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,803.84 | Facility | None | $1,318.26 | $4,073.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,318.26 | Professional | None | $371.54 | $562.34 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $371.54 Median $501.19 Typical High $2,238.72 | Facility | None | $371.54 | $501.19 | $2,238.72 |
Univera Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Professional | None | $371.54 | $489.78 | $724.44 |
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 $269.15 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 53 · Discontinued | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $398.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $245.47 | $389.05 | $575.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $102.33 Typical High $151.36 | Professional | 55 · Aftercare only | $66.07 | $102.33 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $72.44 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $501.19 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $426.58 | Professional | 53 · Discontinued | $281.84 | $288.40 | $426.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $245.47 | $389.05 | $575.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $102.33 Typical High $302.00 | Professional | 55 · Aftercare only | $66.07 | $102.33 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $141.25 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $501.19 |
Where New York sits
The same service costs 7.9 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 $13,941MT $1,762
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.