How much rates vary
Facilitymedian $3,715 · 10th to 90th $832 to $9,120Professionalmedian $145 · 10th to 90th $102 to $219
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 $4,168.69 Typical High $8,128.31 | Facility | None | $1,659.59 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | None | $162.18 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | None | $125.89 | $147.91 | $208.93 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,096.48 | $1,778.28 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $316.23 | Professional | None | $120.23 | $123.03 | $316.23 |
Emblem Health Setting Facility Modifier None Typical Low $144.54 Median $181.97 Typical High $549.54 | Facility | None | $144.54 | $181.97 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $269.15 | Professional | None | $134.90 | $138.04 | $269.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $204.17 | Professional | None | $102.33 | $138.04 | $204.17 |
MVP Health Care Setting Facility Modifier None Typical Low $218.78 Median $1,819.70 Typical High $8,511.38 | Facility | None | $218.78 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $208.93 | Professional | None | $79.43 | $79.43 | $208.93 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $218.78 | Professional | None | $100.00 | $141.25 | $218.78 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $138.04 Typical High $288.40 | Facility | None | $97.72 | $138.04 | $288.40 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $204.17 | Professional | None | $102.33 | $138.04 | $204.17 |
5 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 $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $32.36 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $16.22 | $18.20 | $18.20 |
Where New York sits
The same service costs 11.1 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 $5,221MT $469
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.