How much rates vary
Facilitymedian $3,311 · 10th to 90th $955 to $7,413Professionalmedian $245 · 10th to 90th $195 to $372
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 $4,265.80 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
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 $208.93 Median $245.47 Typical High $346.74 | Professional | None | $208.93 | $245.47 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $363.08 Typical High $512.86 | Professional | 50 · Both sides | $309.03 | $363.08 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $131.83 Median $154.88 Typical High $213.80 | Professional | 62 · Two surgeons | $131.83 | $154.88 | $213.80 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $3,715.35 | Facility | None | $954.99 | $1,819.70 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $575.44 | Professional | None | $204.17 | $213.80 | $575.44 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $234.42 Typical High $794.33 | Facility | None | $60.26 | $234.42 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $380.19 | Professional | None | $223.87 | $239.88 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $338.84 | Professional | None | $138.04 | $208.93 | $338.84 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $3,235.94 Typical High $4,365.16 | Facility | None | $251.19 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $389.05 | Professional | None | $234.42 | $234.42 | $389.05 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $398.11 | Professional | None | $162.18 | $263.03 | $398.11 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $1,000.00 | Facility | None | $223.87 | $245.47 | $1,000.00 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $338.84 | Professional | None | $138.04 | $208.93 | $338.84 |
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 $154.88 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 54 · Surgery only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $34.67 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $162.18 | $223.87 |
Where New York sits
The same service costs 6.4 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 $4,783MT $743
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.