How much rates vary
Facilitymedian $3,162 · 10th to 90th $813 to $7,413Professionalmedian $331 · 10th to 90th $166 to $417
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 $1,479.11 Median $4,073.80 Typical High $8,128.31 | Facility | None | $1,479.11 | $4,073.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $549.54 | Professional | None | $234.42 | $245.47 | $549.54 |
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 $302.00 Median $363.08 Typical High $416.87 | Professional | None | $302.00 | $363.08 | $416.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $229.09 Typical High $263.03 | Professional | 62 · Two surgeons | $190.55 | $229.09 | $263.03 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,071.52 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $562.34 | Professional | None | $151.36 | $158.49 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $724.44 | Facility | None | $204.17 | $316.23 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $354.81 | Professional | None | $177.83 | $177.83 | $354.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $257.04 | Professional | None | $131.83 | $169.82 | $257.04 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $1,819.70 Typical High $8,511.38 | Facility | None | $275.42 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
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 $128.82 Median $181.97 Typical High $316.23 | Professional | None | $128.82 | $181.97 | $316.23 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $977.24 | Facility | None | $125.89 | $177.83 | $977.24 |
Univera Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $257.04 | Professional | None | $131.83 | $177.83 | $257.04 |
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 $117.49 Median $117.49 Typical High $269.15 | Professional | 52 · Reduced service | $117.49 | $117.49 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $109.65 | Professional | 53 · Discontinued | $46.77 | $46.77 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $407.38 | Professional | 54 · Surgery only | $177.83 | $177.83 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $81.28 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $54.95 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $54.95 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $199.53 | Professional | 53 · Discontinued | $104.71 | $131.83 | $199.53 |
Where New York sits
The same service costs 6.8 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 $4,179MT $618
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.