How much rates vary
Facilitymedian $5,370 · 10th to 90th $851 to $14,125Professionalmedian $603 · 10th to 90th $447 to $1,072
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 $630.96 Median $724.44 Typical High $1,698.24 | Professional | None | $630.96 | $724.44 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $912.01 | Professional | None | $501.19 | $602.56 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $97.72 Typical High $144.54 | Professional | 80 · Assistant surgeon | $81.28 | $97.72 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $85.11 Typical High $128.82 | Professional | AS · PA/NP assist | $70.79 | $85.11 | $128.82 |
CDPHP Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,778.28 | Professional | None | $478.63 | $602.56 | $1,778.28 |
Emblem Health Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,905.46 | Facility | None | $501.19 | $912.01 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $870.96 | Professional | None | $457.09 | $524.81 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $630.96 | Professional | None | $295.12 | $436.52 | $630.96 |
MVP Health Care Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,412.54 | Professional | None | $954.99 | $954.99 | $1,412.54 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $354.81 Median $691.83 Typical High $1,778.28 | Professional | None | $354.81 | $691.83 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $436.52 Typical High $1,230.27 | Facility | None | $316.23 | $436.52 | $1,230.27 |
Univera Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $630.96 | Professional | None | $295.12 | $436.52 | $630.96 |
5 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 $316.23 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $72.44 |
Where New York sits
The same service costs 13.6 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 $15,162MD $1,112
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.