How much rates vary
Facilitymedian $3,162 · 10th to 90th $813 to $7,413Professionalmedian $257 · 10th to 90th $200 to $457
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | None | $295.12 | $309.03 | $309.03 |
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 $213.80 Median $251.19 Typical High $346.74 | Professional | None | $213.80 | $251.19 | $346.74 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $2,570.40 | Facility | None | $870.96 | $1,288.25 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $602.56 | Professional | None | $213.80 | $218.78 | $602.56 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $912.01 | Facility | None | $218.78 | $269.15 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $416.87 | Professional | None | $263.03 | $263.03 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $549.54 | Professional | None | $181.97 | $218.78 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $4,365.16 Typical High $38,018.94 | Facility | None | $275.42 | $4,365.16 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $645.65 | Professional | None | $275.42 | $288.40 | $645.65 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $691.83 | Professional | None | $151.36 | $281.84 | $691.83 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $302.00 Typical High $912.01 | Facility | None | $234.42 | $302.00 | $912.01 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $549.54 | Professional | None | $181.97 | $218.78 | $549.54 |
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 $147.91 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $30.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $218.78 | Professional | 53 · Discontinued | $138.04 | $147.91 | $218.78 |
Where New York sits
The same service costs 6.0 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 $4,737MT $787
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.