How much rates vary
Facilitymedian $3,236 · 10th to 90th $813 to $7,413Professionalmedian $166 · 10th to 90th $132 to $355
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 $3,981.07 Typical High $8,128.31 | Facility | None | $1,659.59 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $630.96 | Professional | None | $181.97 | $181.97 | $630.96 |
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 $141.25 Median $165.96 Typical High $309.03 | Professional | None | $141.25 | $165.96 | $309.03 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $125.89 Median $213.80 Typical High $724.44 | Professional | None | $125.89 | $213.80 | $724.44 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $223.87 Typical High $616.60 | Facility | None | $173.78 | $223.87 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $302.00 | Professional | None | $169.82 | $186.21 | $302.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $208.93 | Professional | None | $112.20 | $151.36 | $208.93 |
MVP Health Care Setting Facility Modifier None Typical Low $186.21 Median $4,365.16 Typical High $8,511.38 | Facility | None | $186.21 | $4,365.16 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $416.87 | Professional | None | $263.03 | $269.15 | $416.87 |
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 $120.23 Median $181.97 Typical High $467.74 | Professional | None | $120.23 | $181.97 | $467.74 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $676.08 | Facility | None | $123.03 | $154.88 | $676.08 |
Univera Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $208.93 | Professional | None | $112.20 | $151.36 | $208.93 |
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 $91.20 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $169.82 | Professional | 53 · Discontinued | $91.20 | $117.49 | $169.82 |
Where New York sits
The same service costs 9.2 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 $4,822MT $526
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.