How much rates vary
Facilitymedian $3,388 · 10th to 90th $380 to $8,913Professionalmedian $776 · 10th to 90th $68 to $1,622
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 $138.04 Median $3,467.37 Typical High $7,762.47 | Facility | None | $138.04 | $3,467.37 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $794.33 Typical High $1,202.26 | Professional | None | $57.54 | $794.33 | $1,202.26 |
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 $660.69 Median $776.25 Typical High $1,698.24 | Professional | None | $660.69 | $776.25 | $1,698.24 |
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 $72.44 Median $72.44 Typical High $1,412.54 | Professional | None | $72.44 | $72.44 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,754.23 | Facility | None | $676.08 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $309.03 Typical High $2,290.87 | Professional | None | $42.66 | $309.03 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $51.29 Median $75.86 Typical High $181.97 | Facility | None | $51.29 | $75.86 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,778.28 | Professional | None | $954.99 | $1,071.52 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,288.25 | Professional | None | $562.34 | $794.33 | $1,288.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,698.24 Typical High $8,511.38 | Facility | None | $831.76 | $1,698.24 | $8,511.38 |
MVP Health Care Setting Facility Modifier None Typical Low $72.44 Median $5,888.44 Typical High $8,511.38 | Facility | None | $72.44 | $5,888.44 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,348.96 | $2,137.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,412.54 Typical High $4,365.16 | Facility | None | $363.08 | $1,412.54 | $4,365.16 |
United Setting Professional Modifier None Typical Low $40.74 Median $407.38 Typical High $1,995.26 | Professional | None | $40.74 | $407.38 | $1,995.26 |
Univera Setting Facility Modifier None Typical Low $41.69 Median $162.18 Typical High $933.25 | Facility | None | $41.69 | $162.18 | $933.25 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,174.90 | Professional | None | $562.34 | $794.33 | $1,174.90 |
5 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 $28.84 Median $389.05 Typical High $588.84 | Professional | 52 · Reduced service | $28.84 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $158.49 Typical High $234.42 | Professional | 53 · Discontinued | $11.48 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $588.84 Typical High $870.96 | Professional | 54 · Surgery only | $42.66 | $588.84 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $117.49 Typical High $173.78 | Professional | 55 · Aftercare only | $8.71 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $77.62 Typical High $117.49 | Professional | 56 · Pre-op care only | $5.75 | $77.62 | $117.49 |
Where New York sits
The same service costs 24.5 times more in Alabama 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
AL $7,078MT $289
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.