How much rates vary
Facilitymedian $3,090 · 10th to 90th $741 to $7,413Professionalmedian $380 · 10th to 90th $219 to $562
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 $575.44 Median $3,801.89 Typical High $7,943.28 | Facility | None | $575.44 | $3,801.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $549.54 | Professional | None | $288.40 | $467.74 | $549.54 |
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 $323.59 Median $380.19 Typical High $616.60 | Professional | None | $323.59 | $380.19 | $616.60 |
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 $338.84 Median $338.84 Typical High $630.96 | Professional | None | $338.84 | $338.84 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,479.11 Typical High $2,238.72 | Facility | None | $794.33 | $1,479.11 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $630.96 | Professional | None | $181.97 | $346.74 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $870.96 | Facility | None | $245.47 | $316.23 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $371.54 Typical High $436.52 | Professional | None | $162.18 | $371.54 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $562.34 | Professional | None | $288.40 | $436.52 | $562.34 |
Highmark BCBS Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $1,819.70 Typical High $8,511.38 | Facility | None | $346.74 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $6,165.95 | Facility | None | $812.83 | $2,137.96 | $6,165.95 |
United Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $537.03 | Professional | None | $177.83 | $338.84 | $537.03 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $1,513.56 | Facility | None | $177.83 | $407.38 | $1,513.56 |
Univera Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $562.34 | Professional | None | $288.40 | $436.52 | $562.34 |
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 $141.25 Median $218.78 Typical High $275.42 | Professional | 52 · Reduced service | $141.25 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $57.54 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $213.80 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $42.66 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $28.84 | $43.65 | $54.95 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $281.84 Typical High $436.52 | Professional | 53 · Discontinued | $218.78 | $281.84 | $436.52 |
Where New York sits
The same service costs 4.3 times more in Colorado than in North Dakota. 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 $4,191ND $964
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.