How much rates vary
Facilitymedian $3,890 · 10th to 90th $933 to $9,333Professionalmedian $191 · 10th to 90th $155 to $417
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 $645.65 Median $4,265.80 Typical High $8,128.31 | Facility | None | $645.65 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $537.03 | Professional | None | $239.88 | $245.47 | $537.03 |
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 $154.88 Median $181.97 Typical High $380.19 | Professional | None | $154.88 | $181.97 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $275.42 Typical High $562.34 | Professional | 50 · Both sides | $234.42 | $275.42 | $562.34 |
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 $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $5,623.41 | Facility | None | $954.99 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $831.76 | Professional | None | $181.97 | $257.04 | $831.76 |
Emblem Health Setting Facility Modifier None Typical Low $162.18 Median $239.88 Typical High $741.31 | Facility | None | $162.18 | $239.88 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $389.05 | Professional | None | $208.93 | $234.42 | $389.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $302.00 | Professional | None | $141.25 | $186.21 | $302.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $4,570.88 | Facility | None | $2,187.76 | $2,187.76 | $4,570.88 |
MVP Health Care Setting Facility Modifier None Typical Low $234.42 Median $3,235.94 Typical High $4,365.16 | Facility | None | $234.42 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $524.81 | Professional | None | $309.03 | $309.03 | $524.81 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $575.44 | Professional | None | $147.91 | $218.78 | $575.44 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $186.21 Typical High $724.44 | Facility | None | $120.23 | $186.21 | $724.44 |
Univera Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $302.00 | Professional | None | $141.25 | $186.21 | $302.00 |
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 $123.03 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $186.21 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $190.55 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $309.03 | Professional | 54 · Surgery only | $128.82 | $165.96 | $309.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $33.88 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $33.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.13 | $18.62 | $33.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $147.91 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $114.82 | $147.91 | $269.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $141.25 Typical High $213.80 | Professional | 53 · Discontinued | $107.15 | $141.25 | $213.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $165.96 | $275.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $41.69 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $41.69 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $14.13 | $18.62 | $41.69 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $147.91 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $114.82 | $147.91 | $245.47 |
Where New York sits
The same service costs 9.6 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 $6,197MT $647
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.