How much rates vary
Facilitymedian $3,162 · 10th to 90th $794 to $7,244Professionalmedian $288 · 10th to 90th $117 to $479
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 $1,348.96 Median $3,801.89 Typical High $7,762.47 | Facility | None | $1,348.96 | $3,801.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $436.52 | Professional | None | $158.49 | $288.40 | $436.52 |
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 $251.19 Median $295.12 Typical High $478.63 | Professional | None | $251.19 | $295.12 | $478.63 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $549.54 | Professional | None | $181.97 | $181.97 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $3,090.30 | Facility | None | $954.99 | $1,548.82 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $316.23 Typical High $562.34 | Professional | None | $102.33 | $316.23 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $489.78 | Facility | None | $138.04 | $177.83 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $851.14 | Professional | None | $363.08 | $501.19 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $117.49 Median $338.84 Typical High $501.19 | Professional | None | $117.49 | $338.84 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $1,819.70 Typical High $8,511.38 | Facility | None | $173.78 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $489.78 | Professional | None | $173.78 | $173.78 | $489.78 |
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 $97.72 Median $263.03 Typical High $416.87 | Professional | None | $97.72 | $263.03 | $416.87 |
Univera Setting Facility Modifier None Typical Low $83.18 Median $363.08 Typical High $1,096.48 | Facility | None | $83.18 | $363.08 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $117.49 Median $363.08 Typical High $489.78 | Professional | None | $117.49 | $363.08 | $489.78 |
6 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 $79.43 Median $144.54 Typical High $218.78 | Professional | 52 · Reduced service | $79.43 | $144.54 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $57.54 Typical High $87.10 | Professional | 53 · Discontinued | $31.62 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $213.80 Typical High $323.59 | Professional | 54 · Surgery only | $120.23 | $213.80 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $42.66 Typical High $66.07 | Professional | 55 · Aftercare only | $23.99 | $42.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $28.84 Typical High $43.65 | Professional | 56 · Pre-op care only | $15.85 | $28.84 | $43.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $239.88 Typical High $354.81 | Professional | 53 · Discontinued | $186.21 | $239.88 | $354.81 |
Where New York sits
The same service costs 5.7 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 $4,090MT $722
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.