How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $7,413Professionalmedian $224 · 10th to 90th $155 to $339
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 $4,168.69 Typical High $8,317.64 | Facility | None | $1,659.59 | $4,168.69 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | None | $245.47 | $281.84 | $281.84 |
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 $223.87 Typical High $316.23 | Professional | None | $190.55 | $223.87 | $316.23 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $5,128.61 | Facility | None | $1,348.96 | $1,698.24 | $5,128.61 |
CDPHP Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $3,162.28 | Facility | None | $1,096.48 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $489.78 | Professional | None | $177.83 | $186.21 | $489.78 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $295.12 Typical High $851.14 | Facility | None | $218.78 | $295.12 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $416.87 | Professional | None | $208.93 | $245.47 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $316.23 | Professional | None | $154.88 | $208.93 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $288.40 Median $1,819.70 Typical High $8,511.38 | Facility | None | $288.40 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $346.74 | Professional | None | $144.54 | $144.54 | $346.74 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $6,309.57 | Facility | None | $851.14 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $338.84 | Professional | None | $151.36 | $213.80 | $338.84 |
Univera Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $457.09 | Facility | None | $147.91 | $208.93 | $457.09 |
Univera Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $316.23 | Professional | None | $154.88 | $208.93 | $316.23 |
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 $123.03 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $48.98 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $28.18 |
Where New York sits
The same service costs 5.9 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 $4,297MT $726
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.