How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,000 to $7,413Professionalmedian $324 · 10th to 90th $263 to $646
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 $1,348.96 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,348.96 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $741.31 | Professional | None | $407.38 | $436.52 | $741.31 |
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 $263.03 Median $309.03 Typical High $489.78 | Professional | None | $263.03 | $309.03 | $489.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $190.55 Typical High $309.03 | Professional | 62 · Two surgeons | $162.18 | $190.55 | $309.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $48.98 Typical High $77.62 | Professional | 80 · Assistant surgeon | $41.69 | $48.98 | $77.62 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $42.66 Typical High $67.61 | Professional | AS · PA/NP assist | $36.31 | $42.66 | $67.61 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $3,235.94 | Facility | None | $954.99 | $1,621.81 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $851.14 | Professional | None | $323.59 | $323.59 | $851.14 |
Emblem Health Setting Facility Modifier None Typical Low $407.38 Median $724.44 Typical High $1,548.82 | Facility | None | $407.38 | $724.44 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $676.08 | Professional | None | $331.13 | $446.68 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $478.63 | Professional | None | $269.15 | $354.81 | $478.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
MVP Health Care Setting Facility Modifier None Typical Low $331.13 Median $3,235.94 Typical High $4,365.16 | Facility | None | $331.13 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $912.01 | Professional | None | $371.54 | $446.68 | $912.01 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $7,244.36 | Facility | None | $1,096.48 | $2,454.71 | $7,244.36 |
United Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $1,000.00 | Professional | None | $239.88 | $426.58 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $338.84 Typical High $1,548.82 | Facility | None | $331.13 | $338.84 | $1,548.82 |
Univera Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | None | $269.15 | $331.13 | $478.63 |
16 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 $204.17 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $302.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $309.03 | $416.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $63.10 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $63.10 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $52.48 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $52.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $269.15 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $218.78 | $269.15 | $363.08 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 59 · Distinct service | $524.81 | $524.81 | $524.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $309.03 | Professional | 53 · Discontinued | $186.21 | $199.53 | $309.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $309.03 | $416.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $123.03 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $123.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $104.71 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $104.71 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $269.15 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $218.78 | $269.15 | $363.08 |
Where New York sits
The same service costs 4.0 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 $4,866MT $1,221
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.