How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,122 to $10,965Professionalmedian $288 · 10th to 90th $214 to $407
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 $4,677.35 Typical High $9,120.11 | Facility | None | $1,819.70 | $4,677.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $346.74 | Professional | None | $288.40 | $346.74 | $346.74 |
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 $245.47 Median $288.40 Typical High $380.19 | Professional | None | $245.47 | $288.40 | $380.19 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,495.41 Typical High $10,964.78 | Facility | None | $1,318.26 | $5,495.41 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $562.34 | Professional | None | $208.93 | $213.80 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $398.11 Typical High $1,023.29 | Facility | None | $295.12 | $398.11 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $501.19 | Professional | None | $239.88 | $295.12 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $407.38 | Professional | None | $186.21 | $245.47 | $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 $371.54 Median $371.54 Typical High $416.87 | Professional | None | $371.54 | $371.54 | $416.87 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,803.84 | Facility | None | $1,318.26 | $4,073.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $398.11 | Professional | None | $186.21 | $251.19 | $398.11 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $239.88 Typical High $1,445.44 | Facility | None | $177.83 | $239.88 | $1,445.44 |
Univera Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $371.54 | Professional | None | $186.21 | $245.47 | $371.54 |
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 $144.54 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $57.54 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.84 | $34.67 | $34.67 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $186.21 Typical High $275.42 | Professional | 53 · Discontinued | $147.91 | $186.21 | $275.42 |
Where New York sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.