How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,202 to $15,849Professionalmedian $78 · 10th to 90th $63 to $191
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 $1,949.84 Median $6,918.31 Typical High $13,803.84 | Facility | None | $1,949.84 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $275.42 | Professional | None | $85.11 | $85.11 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $173.78 | Professional | None | $63.10 | $74.13 | $173.78 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $2,818.38 | Facility | None | $851.14 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $371.54 | Professional | None | $79.43 | $120.23 | $371.54 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $346.74 | Facility | None | $89.13 | $112.20 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $173.78 | Professional | None | $93.33 | $107.15 | $173.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $117.49 | Professional | None | $61.66 | $77.62 | $117.49 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $234.42 | Professional | None | $89.13 | $89.13 | $234.42 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $281.84 | Professional | None | $58.88 | $97.72 | $281.84 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $309.03 | Facility | None | $67.61 | $87.10 | $309.03 |
Univera Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $107.15 | Professional | None | $61.66 | $77.62 | $107.15 |
3 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 54 · Surgery only Typical Low $63.10 Median $64.57 Typical High $72.44 | Professional | 54 · Surgery only | $63.10 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.55 |
Where New York sits
The same service costs 35.1 times more in Alaska 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
AK $10,153MT $289
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.