How much rates vary
Facilitymedian $3,311 · 10th to 90th $851 to $7,586Professionalmedian $234 · 10th to 90th $141 to $372
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $346.74 | Professional | None | $165.96 | $281.84 | $346.74 |
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 $208.93 Median $245.47 Typical High $389.05 | Professional | None | $208.93 | $245.47 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $371.54 Typical High $588.84 | Professional | 50 · Both sides | $316.23 | $371.54 | $588.84 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $407.38 | Professional | None | $199.53 | $199.53 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,715.35 | Facility | None | $1,148.15 | $1,819.70 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $446.68 | Professional | None | $109.65 | $234.42 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $457.09 | Facility | None | $100.00 | $147.91 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $512.86 | Professional | None | $257.04 | $338.84 | $512.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $363.08 | Professional | None | $151.36 | $239.88 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $131.83 Median $3,235.94 Typical High $4,365.16 | Facility | None | $131.83 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $398.11 | Professional | None | $173.78 | $173.78 | $398.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $363.08 | Professional | None | $107.15 | $213.80 | $363.08 |
Univera Setting Facility Modifier None Typical Low $134.90 Median $257.04 Typical High $549.54 | Facility | None | $134.90 | $257.04 | $549.54 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $363.08 | Professional | None | $151.36 | $257.04 | $363.08 |
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 $83.18 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $83.18 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $33.11 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $263.03 | Professional | 54 · Surgery only | $125.89 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $25.12 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $204.17 | $245.47 | $331.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $36.31 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $36.31 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $213.80 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $213.80 | $295.12 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $239.88 | Professional | 53 · Discontinued | $141.25 | $169.82 | $239.88 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $204.17 | $245.47 | $331.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $53.70 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $53.70 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $53.70 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $53.70 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $213.80 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $213.80 | $295.12 |
Where New York sits
The same service costs 7.6 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 $4,594ND $605
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.