How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,148 to $12,882Professionalmedian $240 · 10th to 90th $191 to $501
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 $4,168.69 Typical High $8,128.31 | Facility | None | $1,659.59 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $870.96 | Professional | None | $263.03 | $263.03 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $446.68 | Professional | None | $204.17 | $239.88 | $446.68 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,981.07 Typical High $7,943.28 | Facility | None | $1,348.96 | $3,981.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $954.99 | Professional | None | $181.97 | $316.23 | $954.99 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $891.25 | Facility | None | $251.19 | $323.59 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $436.52 | Professional | None | $229.09 | $263.03 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | None | $162.18 | $213.80 | $302.00 |
MVP Health Care Setting Facility Modifier None Typical Low $269.15 Median $1,819.70 Typical High $8,511.38 | Facility | None | $269.15 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $616.60 | Professional | None | $371.54 | $371.54 | $616.60 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $676.08 | Professional | None | $177.83 | $263.03 | $676.08 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $562.34 | Facility | None | $177.83 | $218.78 | $562.34 |
Univera Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | None | $162.18 | $213.80 | $302.00 |
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 $199.53 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $29.51 |
Where New York sits
The same service costs 14.7 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 $11,078MT $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.