How much rates vary
Facilitymedian $3,311 · 10th to 90th $977 to $7,586Professionalmedian $437 · 10th to 90th $339 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 $1,479.11 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 $489.78 Median $549.54 Typical High $602.56 | Professional | None | $489.78 | $549.54 | $602.56 |
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 $354.81 Median $416.87 Typical High $616.60 | Professional | None | $354.81 | $416.87 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $630.96 Typical High $933.25 | Professional | 50 · Both sides | $537.03 | $630.96 | $933.25 |
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 $575.44 Median $575.44 Typical High $645.65 | Professional | None | $575.44 | $575.44 | $645.65 |
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 $323.59 Median $371.54 Typical High $912.01 | Professional | None | $323.59 | $371.54 | $912.01 |
Emblem Health Setting Facility Modifier None Typical Low $389.05 Median $457.09 Typical High $1,513.56 | Facility | None | $389.05 | $457.09 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $870.96 | Professional | None | $407.38 | $562.34 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $616.60 | Professional | None | $239.88 | $407.38 | $616.60 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $4,365.16 | Facility | None | $436.52 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | None | $562.34 | $602.56 | $645.65 |
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 $323.59 Median $436.52 Typical High $676.08 | Professional | None | $323.59 | $436.52 | $676.08 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $407.38 Typical High $1,584.89 | Facility | None | $389.05 | $407.38 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $616.60 | Professional | None | $239.88 | $407.38 | $616.60 |
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 $245.47 Median $275.42 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $389.05 | $398.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $489.78 | Professional | 54 · Surgery only | $302.00 | $363.08 | $489.78 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $123.03 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $123.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $45.71 Typical High $61.66 | Professional | 56 · Pre-op care only | $38.02 | $45.71 | $61.66 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $426.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $295.12 Typical High $407.38 | Professional | 53 · Discontinued | $234.42 | $295.12 | $407.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $489.78 | Professional | 54 · Surgery only | $302.00 | $363.08 | $489.78 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $181.97 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $181.97 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $45.71 Typical High $91.20 | Professional | 56 · Pre-op care only | $38.02 | $45.71 | $91.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $426.58 |
Where New York sits
The same service costs 3.7 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 $4,915ND $1,319
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.