How much rates vary
Facilitymedian $3,162 · 10th to 90th $617 to $7,586Professionalmedian $234 · 10th to 90th $186 to $603
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $602.56 | Professional | None | $263.03 | $263.03 | $602.56 |
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 $190.55 Median $229.09 Typical High $426.58 | Professional | None | $190.55 | $229.09 | $426.58 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $812.83 | Professional | None | $229.09 | $234.42 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $891.25 | Facility | None | $239.88 | $323.59 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $478.63 | Professional | None | $234.42 | $269.15 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $323.59 | Professional | None | $158.49 | $208.93 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $288.40 Median $3,235.94 Typical High $4,365.16 | Facility | None | $288.40 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | None | $407.38 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $676.08 | Professional | None | $177.83 | $269.15 | $676.08 |
Univera Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $446.68 | Facility | None | $165.96 | $213.80 | $446.68 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $323.59 | Professional | None | $158.49 | $208.93 | $323.59 |
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 $131.83 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $31.62 |
Where New York sits
The same service costs 7.1 times more in Alaska 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
AK $5,199MT $735
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.