How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,288 to $12,303Professionalmedian $589 · 10th to 90th $468 to $933
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 $5,888.44 Typical High $12,022.64 | Facility | None | $1,819.70 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | None | $660.69 | $741.31 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $933.25 | Professional | None | $467.74 | $549.54 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $346.74 Typical High $549.54 | Professional | 62 · Two surgeons | $295.12 | $346.74 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $89.13 Typical High $147.91 | Professional | 80 · Assistant surgeon | $75.86 | $89.13 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $125.89 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $125.89 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $5,128.61 Typical High $10,232.93 | Facility | None | $1,445.44 | $5,128.61 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,230.27 | Professional | None | $524.81 | $537.03 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $2,511.89 | Facility | None | $616.60 | $741.31 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,258.93 | Professional | None | $588.84 | $724.44 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $851.14 | Professional | None | $426.58 | $575.44 | $851.14 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $6,456.54 Typical High $7,079.46 | Facility | None | $630.96 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | None | $776.25 | $776.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $954.99 | Professional | None | $457.09 | $602.56 | $954.99 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,398.83 | Facility | None | $407.38 | $588.84 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $851.14 | Professional | None | $426.58 | $575.44 | $851.14 |
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 $331.13 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $524.81 | $524.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $512.86 Typical High $776.25 | Professional | 54 · Surgery only | $316.23 | $512.86 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $57.54 Typical High $85.11 | Professional | 55 · Aftercare only | $34.67 | $57.54 | $85.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $34.67 | $57.54 | $85.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $457.09 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $275.42 | $457.09 | $691.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $446.68 Typical High $602.56 | Professional | 53 · Discontinued | $331.13 | $446.68 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $512.86 Typical High $776.25 | Professional | 54 · Surgery only | $316.23 | $512.86 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $57.54 Typical High $125.89 | Professional | 55 · Aftercare only | $34.67 | $57.54 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $57.54 Typical High $125.89 | Professional | 56 · Pre-op care only | $34.67 | $57.54 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $457.09 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $275.42 | $457.09 | $691.83 |
Where New York sits
The same service costs 5.4 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 $11,084MT $2,070
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.