How much rates vary
Facilitymedian $3,090 · 10th to 90th $234 to $7,413Professionalmedian $100 · 10th to 90th $81 to $162
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,659.59 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $147.91 | Professional | None | $97.72 | $97.72 | $147.91 |
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 $85.11 Median $102.33 Typical High $144.54 | Professional | None | $85.11 | $102.33 | $144.54 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,951.21 | Facility | None | $1,047.13 | $1,737.80 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $190.55 | Professional | None | $79.43 | $85.11 | $190.55 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $120.23 Typical High $371.54 | Facility | None | $97.72 | $120.23 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $177.83 | Professional | None | $107.15 | $117.49 | $177.83 |
Excellus BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $169.82 | Professional | None | $75.86 | $102.33 | $169.82 |
MVP Health Care Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $158.49 | Professional | None | $85.11 | $85.11 | $158.49 |
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 $67.61 Median $112.20 Typical High $190.55 | Professional | None | $67.61 | $112.20 | $190.55 |
Univera Setting Facility Modifier None Typical Low $79.43 Median $151.36 Typical High $251.19 | Facility | None | $79.43 | $151.36 | $251.19 |
Univera Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $169.82 | Professional | None | $75.86 | $120.23 | $169.82 |
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 $48.98 Median $48.98 Typical High $74.13 | Professional | 52 · Reduced service | $48.98 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $29.51 | Professional | 53 · Discontinued | $19.50 | $19.50 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $109.65 | Professional | 54 · Surgery only | $74.13 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $21.88 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $14.79 |
Where New York sits
The same service costs 13.7 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 $4,510MT $328
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.