How much rates vary
Facilitymedian $3,236 · 10th to 90th $851 to $7,413Professionalmedian $282 · 10th to 90th $224 to $427
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 $1,513.56 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,513.56 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $354.81 | Professional | None | $309.03 | $354.81 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $239.88 Median $281.84 Typical High $416.87 | Professional | None | $239.88 | $281.84 | $416.87 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $229.09 Median $234.42 Typical High $616.60 | Professional | None | $229.09 | $234.42 | $616.60 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $524.81 Typical High $1,071.52 | Facility | None | $302.00 | $524.81 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $524.81 | Professional | None | $263.03 | $309.03 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | None | $199.53 | $263.03 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $331.13 Median $1,819.70 Typical High $8,511.38 | Facility | None | $331.13 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
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 $190.55 Median $269.15 Typical High $436.52 | Professional | None | $190.55 | $269.15 | $436.52 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $1,348.96 | Facility | None | $190.55 | $263.03 | $1,348.96 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | None | $199.53 | $263.03 | $398.11 |
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 $154.88 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.90 | $35.48 | $35.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $199.53 Typical High $295.12 | Professional | 53 · Discontinued | $158.49 | $199.53 | $295.12 |
Where New York sits
The same service costs 4.9 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 $4,621MT $935
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.