How much rates vary
Facilitymedian $60 · 10th to 90th $41 to $117Professionalmedian $37 · 10th to 90th $17 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 $48.98 Typical High $60.26 | Facility | None | $34.67 | $48.98 | $60.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $34.67 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $112.20 | Facility | None | $56.23 | $56.23 | $112.20 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $37.15 Median $75.86 Typical High $147.91 | Professional | None (both parts) | $37.15 | $75.86 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $5.75 | Professional | RR · Rental | $3.89 | $3.89 | $5.75 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Facility | None | $40.74 | $40.74 | $50.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None (both parts) | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $204.17 | Facility | None | $56.23 | $93.33 | $204.17 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $52.48 Median $61.66 Typical High $97.72 | Professional | None (both parts) | $52.48 | $61.66 | $97.72 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $53.70 Median $61.66 Typical High $66.07 | Professional | None (both parts) | $53.70 | $61.66 | $66.07 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $40.74 | Professional | None (both parts) | $17.38 | $17.38 | $40.74 |
United Setting Professional Modifier None (both parts) Typical Low $20.42 Median $37.15 Typical High $46.77 | Professional | None (both parts) | $20.42 | $37.15 | $46.77 |
Univera Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $63.10 | Facility | None | $61.66 | $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 |
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 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $9.12 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.03 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | KX · Policy requirements met | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $40.74 Median $53.70 Typical High $77.62 | Professional | 26 · Professional part | $40.74 | $53.70 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $28.84 Typical High $79.43 | Professional | UE · Used equipment | $25.12 | $28.84 | $79.43 |
Where New York sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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· 36th of 51
$37.15
HI $79.43WY $12.02
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.