How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,445 to $26,303Professionalmedian $363 · 10th to 90th $295 to $661
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 $2,570.40 Median $7,585.78 Typical High $15,488.17 | Facility | None | $2,570.40 | $7,585.78 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $4,570.88 | Professional | None | $363.08 | $363.08 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $602.56 | Professional | None | $316.23 | $380.19 | $602.56 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
CDPHP Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $95,499.26 Typical High $134,896.29 | Facility | None | $1,096.48 | $95,499.26 | $134,896.29 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $1,122.02 | Professional | None | $338.84 | $346.74 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $1,318.26 | Facility | None | $309.03 | $512.86 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $630.96 | Professional | None | $338.84 | $363.08 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $478.63 | Professional | None | $218.78 | $269.15 | $478.63 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $851.14 | Professional | None | $295.12 | $295.12 | $851.14 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $5,888.44 Typical High $34,673.69 | Facility | None | $1,412.54 | $5,888.44 | $34,673.69 |
United Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $977.24 | Professional | None | $239.88 | $371.54 | $977.24 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $426.58 Typical High $512.86 | Facility | None | $234.42 | $426.58 | $512.86 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $478.63 | Professional | None | $199.53 | $269.15 | $478.63 |
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 $181.97 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $269.15 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $44.67 |
Where New York sits
The same service costs 45.0 times more in New Mexico 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
NM $44,130MT $980
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.