How much rates vary
Facilitymedian $3,020 · 10th to 90th $347 to $7,413Professionalmedian $257 · 10th to 90th $151 to $525
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 $158.49 Median $2,951.21 Typical High $7,762.47 | Facility | None | $158.49 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $309.03 Typical High $489.78 | Professional | None | $151.36 | $309.03 | $489.78 |
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 $218.78 Median $257.04 Typical High $501.19 | Professional | None | $218.78 | $257.04 | $501.19 |
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 $190.55 Median $190.55 Typical High $363.08 | Professional | None | $190.55 | $190.55 | $363.08 |
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 $97.72 Median $194.98 Typical High $812.83 | Professional | None | $97.72 | $194.98 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $194.98 Typical High $501.19 | Facility | None | $138.04 | $194.98 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $562.34 | Professional | None | $323.59 | $354.81 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $316.23 | Professional | None | $169.82 | $275.42 | $316.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $5,370.32 | Facility | None | $1,513.56 | $2,290.87 | $5,370.32 |
MVP Health Care Setting Facility Modifier None Typical Low $154.88 Median $4,365.16 Typical High $8,511.38 | Facility | None | $154.88 | $4,365.16 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $616.60 | Professional | None | $257.04 | $257.04 | $616.60 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,760.83 | Facility | None | $831.76 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $575.44 | Professional | None | $107.15 | $229.09 | $575.44 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $691.83 | Facility | None | $97.72 | $234.42 | $691.83 |
Univera Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $309.03 | Professional | None | $169.82 | $263.03 | $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 $75.86 Median $138.04 Typical High $162.18 | Professional | 52 · Reduced service | $75.86 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $30.20 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $114.82 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $41.69 Typical High $48.98 | Professional | 55 · Aftercare only | $22.91 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.14 | $27.54 | $32.36 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $165.96 Typical High $269.15 | Professional | 53 · Discontinued | $125.89 | $165.96 | $269.15 |
Where New York sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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 $4,192WV $514
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.