How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $7,413Professionalmedian $174 · 10th to 90th $138 to $295
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 $3,981.07 Typical High $8,128.31 | Facility | None | $1,659.59 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | None | $190.55 | $213.80 | $213.80 |
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 $147.91 Median $173.78 Typical High $245.47 | Professional | None | $147.91 | $173.78 | $245.47 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $3,090.30 | Facility | None | $1,071.52 | $1,584.89 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $380.19 | Professional | None | $138.04 | $144.54 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $676.08 | Facility | None | $186.21 | $323.59 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $323.59 | Professional | None | $162.18 | $190.55 | $323.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $234.42 | Professional | None | $120.23 | $154.88 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $223.87 Median $1,819.70 Typical High $8,511.38 | Facility | None | $223.87 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | None | $295.12 | $295.12 | $363.08 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $6,309.57 | Facility | None | $851.14 | $2,137.96 | $6,309.57 |
United Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $263.03 | Professional | None | $117.49 | $165.96 | $263.03 |
Univera Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $1,096.48 | Facility | None | $114.82 | $162.18 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $234.42 | Professional | None | $120.23 | $162.18 | $234.42 |
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 $93.33 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $38.02 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $21.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $123.03 Typical High $181.97 | Professional | 53 · Discontinued | $95.50 | $123.03 | $181.97 |
Where New York sits
The same service costs 7.3 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 $4,136MT $564
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.