How much rates vary
Facilitymedian $3,090 · 10th to 90th $776 to $7,413Professionalmedian $166 · 10th to 90th $132 to $282
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 $1,348.96 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,348.96 | $3,890.45 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $218.78 | Professional | None | $177.83 | $204.17 | $218.78 |
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 $141.25 Median $165.96 Typical High $239.88 | Professional | None | $141.25 | $165.96 | $239.88 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,238.72 | Facility | None | $794.33 | $1,258.93 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $389.05 | Professional | None | $128.82 | $134.90 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $177.83 Median $389.05 Typical High $676.08 | Facility | None | $177.83 | $389.05 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $302.00 | Professional | None | $151.36 | $177.83 | $302.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $229.09 | Professional | None | $112.20 | $151.36 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $245.47 Median $1,819.70 Typical High $8,511.38 | Facility | None | $245.47 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | None | $281.84 | $281.84 | $363.08 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $6,309.57 | Facility | None | $831.76 | $2,137.96 | $6,309.57 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $257.04 | Professional | None | $112.20 | $154.88 | $257.04 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $977.24 | Facility | None | $125.89 | $151.36 | $977.24 |
Univera Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $229.09 | Professional | None | $112.20 | $151.36 | $229.09 |
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 $89.13 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $89.13 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $21.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $169.82 |
Where New York sits
The same service costs 7.7 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 $4,047MT $526
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.