How much rates vary
Facilitymedian $4,677 · 10th to 90th $933 to $10,965Professionalmedian $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 $1,819.70 Median $5,011.87 Typical High $8,317.64 | Facility | None | $1,819.70 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $354.81 | Professional | None | $302.00 | $346.74 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $389.05 | Professional | None | $239.88 | $281.84 | $389.05 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $7,244.36 Typical High $14,454.40 | Facility | None | $1,318.26 | $7,244.36 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $602.56 | Professional | None | $223.87 | $229.09 | $602.56 |
Emblem Health Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $1,047.13 | Facility | None | $269.15 | $354.81 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $501.19 | Professional | None | $295.12 | $302.00 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $426.58 | Professional | None | $190.55 | $295.12 | $426.58 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $1,819.70 Typical High $8,511.38 | Facility | None | $275.42 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | None | $380.19 | $380.19 | $389.05 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,760.83 | Facility | None | $831.76 | $2,238.72 | $6,760.83 |
United Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $416.87 | Professional | None | $186.21 | $263.03 | $416.87 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $812.83 | Facility | None | $213.80 | $302.00 | $812.83 |
Univera Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $426.58 | Professional | None | $190.55 | $295.12 | $426.58 |
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 $151.36 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $34.67 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $151.36 | $194.98 | $269.15 |
Where New York sits
The same service costs 7.8 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 $7,005MT $893
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.