How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,000 to $9,120Professionalmedian $851 · 10th to 90th $676 to $2,138
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 $6,025.60 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,230.27 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $9,332.54 | Facility | None | $1,288.25 | $3,981.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,949.84 | Professional | None | $660.69 | $794.33 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,174.90 Typical High $2,951.21 | Professional | 50 · Both sides | $1,000.00 | $1,174.90 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $125.89 Typical High $316.23 | Professional | 80 · Assistant surgeon | $104.71 | $125.89 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $275.42 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $275.42 |
CDPHP Setting Facility Modifier None Typical Low $3,019.95 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,019.95 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $1,096.48 Median $1,122.02 Typical High $3,715.35 | Professional | None | $1,096.48 | $1,122.02 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $3,890.45 | Facility | None | $1,122.02 | $1,479.11 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,258.93 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,479.11 | Professional | None | $707.95 | $912.01 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,348.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,548.82 | $2,818.38 |
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 $831.76 Median $1,230.27 Typical High $3,235.94 | Professional | None | $831.76 | $1,230.27 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $2,089.30 | Facility | None | $758.58 | $1,000.00 | $2,089.30 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,479.11 | Professional | None | $707.95 | $912.01 | $1,479.11 |
14 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 $616.60 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $851.14 Typical High $1,412.54 | Professional | 54 · Surgery only | $660.69 | $851.14 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $107.15 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $107.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $83.18 Typical High $138.04 | Professional | 56 · Pre-op care only | $63.10 | $83.18 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $776.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $588.84 | $776.25 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $891.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $660.69 | $891.25 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $138.04 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $138.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $87.10 Typical High $177.83 | Professional | 56 · Pre-op care only | $63.10 | $87.10 | $177.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $812.83 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $588.84 | $812.83 | $1,230.27 |
Where New York sits
The same service costs 7.5 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 $13,030MD $1,737
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.