How much rates vary
Facilitymedian $3,236 · 10th to 90th $851 to $7,413Professionalmedian $269 · 10th to 90th $214 to $407
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 $1,584.89 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,584.89 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | None | $295.12 | $338.84 | $338.84 |
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 $229.09 Median $269.15 Typical High $389.05 | Professional | None | $229.09 | $269.15 | $389.05 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $213.80 Median $223.87 Typical High $588.84 | Professional | None | $213.80 | $223.87 | $588.84 |
Emblem Health Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $1,023.29 | Facility | None | $288.40 | $501.19 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $501.19 | Professional | None | $251.19 | $251.19 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $371.54 | Professional | None | $190.55 | $245.47 | $371.54 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $1,819.70 Typical High $8,511.38 | Facility | None | $309.03 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | None | $371.54 | $371.54 | $426.58 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,187.76 Typical High $6,309.57 | Facility | None | $831.76 | $2,187.76 | $6,309.57 |
United Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $407.38 | Professional | None | $181.97 | $257.04 | $407.38 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $1,258.93 | Facility | None | $177.83 | $251.19 | $1,258.93 |
Univera Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $363.08 | Professional | None | $190.55 | $251.19 | $363.08 |
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 $147.91 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $33.88 | $33.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $190.55 Typical High $281.84 | Professional | 53 · Discontinued | $151.36 | $190.55 | $281.84 |
Where New York sits
The same service costs 5.2 times more in Oklahoma 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
OK $4,508MT $873
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.