How much rates vary
Facilitymedian $4,074 · 10th to 90th $776 to $10,233Professionalmedian $617 · 10th to 90th $204 to $1,259
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 $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $630.96 Typical High $831.76 | Professional | None | $199.53 | $630.96 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,071.52 | Professional | None | $537.03 | $645.65 | $1,071.52 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $912.01 | Professional | None | $257.04 | $257.04 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,023.29 Typical High $1,659.59 | Facility | None | $549.54 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $478.63 Typical High $1,202.26 | Professional | None | $138.04 | $478.63 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $181.97 Median $251.19 Typical High $645.65 | Facility | None | $181.97 | $251.19 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,174.90 | Professional | None | $616.60 | $724.44 | $1,174.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $812.83 | Professional | None | $380.19 | $549.54 | $812.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $870.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,288.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $162.18 Median $501.19 Typical High $1,148.15 | Professional | None | $162.18 | $501.19 | $1,148.15 |
Univera Setting Facility Modifier None Typical Low $128.82 Median $562.34 Typical High $2,454.71 | Facility | None | $128.82 | $562.34 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $794.33 | Professional | None | $380.19 | $549.54 | $794.33 |
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 $97.72 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $97.72 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $125.89 Typical High $165.96 | Professional | 53 · Discontinued | $39.81 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $467.74 Typical High $630.96 | Professional | 54 · Surgery only | $147.91 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $95.50 Typical High $125.89 | Professional | 55 · Aftercare only | $29.51 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $19.95 | $63.10 | $83.18 |
Where New York sits
The same service costs 6.9 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 $7,377MT $1,063
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.