How much rates vary
Facilitymedian $62 · 10th to 90th $45 to $138Professionalmedian $49 · 10th to 90th $35 to $66
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 $34.67 Median $50.12 Typical High $64.57 | Facility | None | $34.67 | $50.12 | $64.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $34.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.55 Typical High $69.18 | Professional | RR · Rental | $3.55 | $3.55 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $123.03 | Facility | None | $61.66 | $61.66 | $123.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $114.82 | Professional | None (both parts) | $42.66 | $42.66 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $6.17 | Professional | RR · Rental | $4.27 | $4.27 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Facility | None | $44.67 | $44.67 | $54.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None (both parts) | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $109.65 | $109.65 | $109.65 |
Emblem Health Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $223.87 | Facility | None | $61.66 | $102.33 | $223.87 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $57.54 Median $67.61 Typical High $107.15 | Professional | None (both parts) | $57.54 | $67.61 | $107.15 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | None (both parts) | $56.23 | $61.66 | $66.07 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None (both parts) Typical Low $21.38 Median $38.90 Typical High $52.48 | Professional | None (both parts) | $21.38 | $38.90 | $52.48 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $63.10 | Facility | None | $50.12 | $63.10 | $63.10 |
Univera Setting Professional Modifier None (both parts) Typical Low $37.15 Median $61.66 Typical High $66.07 | Professional | None (both parts) | $37.15 | $61.66 | $66.07 |
4 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 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $9.55 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $6.46 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | MS · Maintenance fee | $3.55 | $3.55 | $5.01 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $53.70 Typical High $77.62 | Professional | 26 · Professional part | $28.84 | $53.70 | $77.62 |
Where New York sits
The same service costs 2.5 times more in Wyoming than in Florida. 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· 25th of 51
$48.98
WY $93.33FL $38.02
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.