How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $9,333Professionalmedian $151 · 10th to 90th $120 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 $1,479.11 Median $4,073.80 Typical High $8,128.31 | Facility | None | $1,479.11 | $4,073.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $562.34 | Professional | None | $173.78 | $173.78 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
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 |
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 $1,148.15 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,148.15 | $2,818.38 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $707.95 | Professional | None | $120.23 | $204.17 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $575.44 | Facility | None | $162.18 | $208.93 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $281.84 | Professional | None | $162.18 | $177.83 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $204.17 | Professional | None | $107.15 | $131.83 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $6,456.54 | Facility | None | $2,137.96 | $5,248.07 | $6,456.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,819.70 Median $5,888.44 Typical High $8,511.38 | Facility | None | $1,819.70 | $5,888.44 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,754.23 | $7,943.28 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $446.68 | Professional | None | $112.20 | $165.96 | $446.68 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $120.23 Typical High $645.65 | Facility | None | $117.49 | $120.23 | $645.65 |
Univera Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $204.17 | Professional | None | $107.15 | $131.83 | $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 $87.10 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $34.67 | $38.02 |
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 $28.84 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $19.05 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $107.15 Typical High $162.18 | Professional | 53 · Discontinued | $81.28 | $107.15 | $162.18 |
Where New York sits
The same service costs 13.0 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 $6,260MT $480
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.