How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,175 to $15,849Professionalmedian $170 · 10th to 90th $132 to $331
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 $1,819.70 Median $6,025.60 Typical High $11,481.54 | Facility | None | $1,819.70 | $6,025.60 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $616.60 | Professional | None | $194.98 | $199.53 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,848.93 | Facility | None | $1,737.80 | $8,709.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $302.00 | Professional | None | $134.90 | $162.18 | $302.00 |
CDPHP Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $12,882.50 | Facility | None | $4,365.16 | $4,365.16 | $12,882.50 |
CDPHP Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,445.44 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $588.84 | Professional | None | $162.18 | $173.78 | $588.84 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $316.23 Typical High $645.65 | Facility | None | $169.82 | $316.23 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $316.23 | Professional | None | $154.88 | $177.83 | $316.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $257.04 | Professional | None | $104.71 | $141.25 | $257.04 |
MVP Health Care Setting Facility Modifier None Typical Low $269.15 Median $6,606.93 Typical High $89,125.09 | Facility | None | $269.15 | $6,606.93 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $416.87 | Professional | None | $218.78 | $218.78 | $416.87 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $21,877.62 | Facility | None | $1,318.26 | $4,073.80 | $21,877.62 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $478.63 | Professional | None | $117.49 | $186.21 | $478.63 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $1,071.52 | Facility | None | $104.71 | $147.91 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $263.03 | Professional | None | $104.71 | $141.25 | $263.03 |
5 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 $100.00 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | 54 · Surgery only | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $21.38 |
Where New York sits
The same service costs 30.9 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 $14,683MT $475
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.