How much rates vary
Facilitymedian $3,388 · 10th to 90th $832 to $7,762Professionalmedian $295 · 10th to 90th $229 to $603
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 $371.54 Median $3,801.89 Typical High $8,128.31 | Facility | None | $371.54 | $3,801.89 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $794.33 | Professional | None | $338.84 | $371.54 | $794.33 |
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 $245.47 Median $288.40 Typical High $537.03 | Professional | None | $245.47 | $288.40 | $537.03 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,621.81 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $1,174.90 | Professional | None | $257.04 | $371.54 | $1,174.90 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $537.03 Typical High $1,096.48 | Facility | None | $309.03 | $537.03 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $537.03 | Professional | None | $281.84 | $323.59 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $478.63 | Professional | None | $213.80 | $257.04 | $478.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $7,079.46 | Facility | None | $2,754.23 | $4,466.84 | $7,079.46 |
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 $407.38 Median $407.38 Typical High $741.31 | Professional | None | $407.38 | $407.38 | $741.31 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $831.76 | Professional | None | $218.78 | $316.23 | $831.76 |
Univera Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $1,148.15 | Facility | None | $251.19 | $263.03 | $1,148.15 |
Univera Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $478.63 | Professional | None | $213.80 | $257.04 | $478.63 |
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 $173.78 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $257.04 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $37.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $204.17 Typical High $302.00 | Professional | 53 · Discontinued | $154.88 | $204.17 | $302.00 |
Where New York sits
The same service costs 6.4 times more in Oklahoma 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
OK $5,884MT $914
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.