How much rates vary
Facilitymedian $3,311 · 10th to 90th $955 to $7,586Professionalmedian $224 · 10th to 90th $182 to $447
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | None | $309.03 | $316.23 | $316.23 |
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 $181.97 Median $213.80 Typical High $354.81 | Professional | None | $181.97 | $213.80 | $354.81 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $223.87 Median $223.87 Typical High $602.56 | Professional | None | $223.87 | $223.87 | $602.56 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $478.63 Typical High $1,071.52 | Facility | None | $275.42 | $478.63 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $467.74 | Professional | None | $239.88 | $302.00 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $331.13 | Professional | None | $208.93 | $251.19 | $331.13 |
MVP Health Care Setting Facility Modifier None Typical Low $302.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $302.00 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $691.83 | Professional | None | $257.04 | $257.04 | $691.83 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $7,244.36 | Facility | None | $1,096.48 | $2,511.89 | $7,244.36 |
United Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $724.44 | Professional | None | $165.96 | $302.00 | $724.44 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $1,318.26 | Facility | None | $239.88 | $245.47 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $323.59 | Professional | None | $208.93 | $245.47 | $323.59 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $213.80 | $218.78 | $218.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $181.97 | $218.78 | $309.03 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $45.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $27.54 Typical High $38.90 | Professional | 56 · Pre-op care only | $22.91 | $27.54 | $38.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $269.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $223.87 | Professional | 53 · Discontinued | $138.04 | $147.91 | $223.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $281.84 | Professional | 54 · Surgery only | $181.97 | $218.78 | $281.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $93.33 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $93.33 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $27.54 Typical High $77.62 | Professional | 56 · Pre-op care only | $22.91 | $27.54 | $77.62 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $245.47 |
Where New York sits
The same service costs 5.6 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 $4,847MT $873
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.