How much rates vary
Facilitymedian $3,236 · 10th to 90th $741 to $7,413Professionalmedian $155 · 10th to 90th $123 to $339
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 $446.68 Median $3,801.89 Typical High $8,128.31 | Facility | None | $446.68 | $3,801.89 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $436.52 | Professional | None | $165.96 | $169.82 | $436.52 |
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 $128.82 Median $151.36 Typical High $288.40 | Professional | None | $128.82 | $151.36 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $229.09 Typical High $436.52 | Professional | 50 · Both sides | $194.98 | $229.09 | $436.52 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $2,884.03 | Facility | None | $1,000.00 | $1,584.89 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $676.08 | Professional | None | $117.49 | $199.53 | $676.08 |
Emblem Health Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $562.34 | Facility | None | $158.49 | $208.93 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $275.42 | Professional | None | $147.91 | $169.82 | $275.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $213.80 | Professional | None | $107.15 | $141.25 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $338.84 Median $616.60 Typical High $2,344.23 | Facility | None | $338.84 | $616.60 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $1,819.70 Typical High $8,511.38 | Facility | None | $173.78 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $389.05 | Professional | None | $186.21 | $186.21 | $389.05 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $3,019.95 Typical High $7,244.36 | Facility | None | $1,122.02 | $3,019.95 | $7,244.36 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $436.52 | Professional | None | $112.20 | $165.96 | $436.52 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $741.31 | Facility | None | $117.49 | $141.25 | $741.31 |
Univera Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $204.17 | Professional | None | $107.15 | $141.25 | $204.17 |
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 $85.11 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $18.62 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $162.18 | Professional | 53 · Discontinued | $79.43 | $104.71 | $162.18 |
Where New York sits
The same service costs 9.8 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 $4,600MT $469
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.