How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $7,413Professionalmedian $229 · 10th to 90th $182 to $407
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 $1,659.59 Median $5,248.07 Typical High $9,120.11 | Facility | None | $1,659.59 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | None | $245.47 | $263.03 | $281.84 |
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 $194.98 Median $229.09 Typical High $346.74 | Professional | None | $194.98 | $229.09 | $346.74 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,071.52 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $562.34 | Professional | None | $257.04 | $257.04 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $316.23 Typical High $891.25 | Facility | None | $234.42 | $316.23 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $426.58 | Professional | None | $229.09 | $257.04 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $309.03 | Professional | None | $134.90 | $199.53 | $309.03 |
MVP Health Care Setting Facility Modifier None Typical Low $239.88 Median $3,235.94 Typical High $4,365.16 | Facility | None | $239.88 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $630.96 | Professional | None | $177.83 | $177.83 | $630.96 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $602.56 | Professional | None | $151.36 | $245.47 | $602.56 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $933.25 | Facility | None | $158.49 | $229.09 | $933.25 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $309.03 | Professional | None | $158.49 | $199.53 | $309.03 |
6 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 $123.03 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $24.55 | $26.30 | $26.30 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $125.89 | $181.97 |
Where New York sits
The same service costs 6.2 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 $4,689MT $752
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.