How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $9,333Professionalmedian $417 · 10th to 90th $339 to $977
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 $1,230.27 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,230.27 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $588.84 | Professional | None | $501.19 | $537.03 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $812.83 | Professional | None | $338.84 | $398.11 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $128.82 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $114.82 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $114.82 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $645.65 | Professional | None | $602.56 | $602.56 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $4,073.80 | Facility | None | $954.99 | $2,089.30 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $1,737.80 | Professional | None | $371.54 | $467.74 | $1,737.80 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $1,548.82 | Facility | None | $251.19 | $457.09 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $954.99 | Professional | None | $537.03 | $602.56 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $660.69 | Professional | None | $309.03 | $416.87 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $457.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,122.02 | Professional | None | $524.81 | $524.81 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $1,174.90 | Professional | None | $316.23 | $457.09 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $1,258.93 | Facility | None | $245.47 | $407.38 | $1,258.93 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $660.69 | Professional | None | $309.03 | $407.38 | $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 $251.19 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $371.54 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $416.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $407.38 Typical High $676.08 | Professional | 54 · Surgery only | $281.84 | $407.38 | $676.08 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $74.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $45.71 Typical High $74.13 | Professional | 56 · Pre-op care only | $30.90 | $45.71 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $588.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $302.00 Typical High $467.74 | Professional | 53 · Discontinued | $234.42 | $302.00 | $467.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $281.84 | $407.38 | $602.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $91.20 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $91.20 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $45.71 Typical High $91.20 | Professional | 56 · Pre-op care only | $30.90 | $45.71 | $91.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $537.03 |
Where New York sits
The same service costs 4.8 times more in Colorado than in North Dakota. 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 $6,549ND $1,369
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.