How much rates vary
Facilitymedian $3,311 · 10th to 90th $912 to $8,913Professionalmedian $813 · 10th to 90th $617 to $1,585
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,862.09 | Professional | None | $912.01 | $912.01 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,445.44 | Professional | None | $645.65 | $776.25 | $1,445.44 |
CDPHP Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $2,818.38 | Professional | None | $812.83 | $831.76 | $2,818.38 |
Emblem Health Setting Facility Modifier None Typical Low $933.25 Median $1,513.56 Typical High $3,235.94 | Facility | None | $933.25 | $1,513.56 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,737.80 | Professional | None | $776.25 | $977.24 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,318.26 | Professional | None | $524.81 | $724.44 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $89,125.09 | Facility | None | $891.25 | $1,819.70 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,258.93 | $2,089.30 |
United Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $21,877.62 | Facility | None | $575.44 | $2,187.76 | $21,877.62 |
United Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $2,398.83 | Professional | None | $660.69 | $912.01 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $2,344.23 | Facility | None | $537.03 | $741.31 | $2,344.23 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,318.26 | Professional | None | $524.81 | $724.44 | $1,318.26 |
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 $676.08 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $676.08 Typical High $1,230.27 | Professional | 54 · Surgery only | $501.19 | $676.08 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $93.33 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $93.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $66.07 Typical High $120.23 | Professional | 56 · Pre-op care only | $47.86 | $66.07 | $120.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $616.60 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $446.68 | $616.60 | $1,122.02 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $676.08 Typical High $1,230.27 | Professional | 54 · Surgery only | $501.19 | $676.08 | $1,230.27 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $107.15 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $107.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $66.07 Typical High $138.04 | Professional | 56 · Pre-op care only | $47.86 | $66.07 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $616.60 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $446.68 | $616.60 | $1,122.02 |
Where New York sits
The same service costs 10.7 times more in Colorado than in Maryland. 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 $15,603MD $1,454
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.