How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,318 to $57,544Professionalmedian $741 · 10th to 90th $575 to $1,288
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 $1,621.81 Median $7,413.10 Typical High $28,183.83 | Facility | None | $1,621.81 | $7,413.10 | $28,183.83 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $2,511.89 | Professional | None | $630.96 | $630.96 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $14,454.40 Typical High $74,131.02 | Facility | None | $1,737.80 | $14,454.40 | $74,131.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,202.26 | Professional | None | $660.69 | $794.33 | $1,202.26 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
CDPHP Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $10,964.78 Median $20,892.96 Typical High $44,668.36 | Facility | None | $10,964.78 | $20,892.96 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $2,187.76 | Professional | None | $707.95 | $741.31 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $2,511.89 | Facility | None | $758.58 | $977.24 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,412.54 | Professional | None | $691.83 | $812.83 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $891.25 | Professional | None | $512.86 | $602.56 | $891.25 |
MVP Health Care Setting Facility Modifier None Typical Low $13,182.57 Median $16,982.44 Typical High $37,153.52 | Facility | None | $13,182.57 | $16,982.44 | $37,153.52 |
MVP Health Care Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,584.89 | Professional | None | $512.86 | $512.86 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,677.35 Typical High $34,673.69 | Facility | None | $1,318.26 | $4,677.35 | $34,673.69 |
United Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,737.80 | Professional | None | $537.03 | $794.33 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $1,905.46 | Facility | None | $616.60 | $630.96 | $1,905.46 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $891.25 | Professional | None | $512.86 | $602.56 | $891.25 |
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 $316.23 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $75.86 |
Where New York sits
The same service costs 9.6 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 $19,472MT $2,030
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.