How much rates vary
Facilitymedian $3,388 · 10th to 90th $912 to $7,762Professionalmedian $479 · 10th to 90th $389 to $724
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 $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
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 $407.38 Median $478.63 Typical High $691.83 | Professional | None | $407.38 | $478.63 | $691.83 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $1,000.00 | Professional | None | $380.19 | $389.05 | $1,000.00 |
Emblem Health Setting Facility Modifier None Typical Low $245.47 Median $524.81 Typical High $1,737.80 | Facility | None | $245.47 | $524.81 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $912.01 | Professional | None | $457.09 | $524.81 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $660.69 | Professional | None | $346.74 | $446.68 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $537.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $537.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $758.58 | Professional | None | $524.81 | $524.81 | $758.58 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,760.83 | Facility | None | $851.14 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $724.44 | Professional | None | $331.13 | $457.09 | $724.44 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $1,862.09 | Facility | None | $323.59 | $457.09 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $660.69 | Professional | None | $346.74 | $457.09 | $660.69 |
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 $263.03 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $416.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $602.56 | Professional | 54 · Surgery only | $251.19 | $380.19 | $602.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $66.07 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $66.07 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $38.02 Typical High $60.26 | Professional | 56 · Pre-op care only | $25.12 | $38.02 | $60.26 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $346.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $223.87 | $346.74 | $537.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $338.84 Typical High $512.86 | Professional | 53 · Discontinued | $263.03 | $338.84 | $512.86 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $602.56 | Professional | 54 · Surgery only | $251.19 | $398.11 | $602.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $44.67 Typical High $109.65 | Professional | 55 · Aftercare only | $27.54 | $44.67 | $109.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $39.81 Typical High $97.72 | Professional | 56 · Pre-op care only | $25.12 | $39.81 | $97.72 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $537.03 |
Where New York sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.