How much rates vary
Facilitymedian $41 · 10th to 90th $35 to $91Professionalmedian $35 · 10th to 90th $26 to $78
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 $24.55 Median $28.84 Typical High $51.29 | Facility | None | $24.55 | $28.84 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $51.29 | Professional | None | $24.55 | $24.55 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $109.65 | Facility | None | $54.95 | $54.95 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $97.72 | Professional | None | $30.90 | $30.90 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $6.76 | Professional | RR · Rental | $3.09 | $3.09 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | UE · Used equipment | $22.91 | $22.91 | $45.71 |
CDPHP Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Emblem Health Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $154.88 | Facility | None | $38.02 | $57.54 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $97.72 | Professional | None | $35.48 | $51.29 | $97.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | None | $36.31 | $40.74 | $44.67 |
MVP Health Care Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
MVP Health Care Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $81.28 | Professional | None | $33.11 | $33.11 | $81.28 |
United Setting Professional Modifier None Typical Low $17.78 Median $33.11 Typical High $43.65 | Professional | None | $17.78 | $33.11 | $43.65 |
Univera Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $42.66 | Facility | None | $36.31 | $40.74 | $42.66 |
Univera Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | None | $36.31 | $40.74 | $44.67 |
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 $12.30 Median $12.30 Typical High $25.70 | Professional | 52 · Reduced service | $12.30 | $12.30 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $10.23 | Professional | 53 · Discontinued | $4.90 | $4.90 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $7.59 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $5.13 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | KX · Policy requirements met | $45.71 | $45.71 | $45.71 |
Where New York sits
The same service costs 2.2 times more in Hawaii than in Utah. 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.
New York· 30th of 51
$35.48
HI $57.54UT $25.70
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.