How much rates vary
Facilitymedian $257 · 10th to 90th $178 to $295Professionalmedian $195 · 10th to 90th $141 to $302
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 $144.54 Median $204.17 Typical High $275.42 | Facility | None | $144.54 | $204.17 | $275.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $204.17 Typical High $275.42 | Professional | None (both parts) | $186.21 | $204.17 | $275.42 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $141.25 Median $151.36 Typical High $204.17 | Professional | UE · Used equipment | $141.25 | $151.36 | $204.17 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $389.05 | Professional | None (both parts) | $194.98 | $194.98 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $60.26 | Professional | RR · Rental | $19.50 | $19.50 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | UE · Used equipment | $144.54 | $144.54 | $151.36 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $28.84 Median $28.84 Typical High $371.54 | Professional | None (both parts) | $28.84 | $28.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $177.83 Typical High $316.23 | Facility | None | $69.18 | $177.83 | $316.23 |
Cigna Setting Facility Modifier RR · Rental Typical Low $7.24 Median $17.78 Typical High $33.11 | Facility | RR · Rental | $7.24 | $17.78 | $33.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | None (both parts) | $151.36 | $151.36 | $190.55 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $19.05 | Professional | RR · Rental | $15.14 | $15.14 | $19.05 |
Cigna Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $114.82 | $114.82 | $114.82 |
Emblem Health Setting Facility Modifier RR · Rental Typical Low $25.12 Median $40.74 Typical High $89.13 | Facility | RR · Rental | $25.12 | $40.74 | $89.13 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $204.17 Median $257.04 Typical High $288.40 | Professional | None (both parts) | $204.17 | $257.04 | $288.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Excellus BCBS Setting Facility Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | RR · Rental | $25.70 | $25.70 | $25.70 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $257.04 Median $281.84 Typical High $302.00 | Professional | None (both parts) | $257.04 | $281.84 | $302.00 |
Excellus BCBS Setting Professional Modifier RR · Rental Typical Low $23.44 Median $27.54 Typical High $30.20 | Professional | RR · Rental | $23.44 | $27.54 | $30.20 |
Excellus BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $162.18 Typical High $213.80 | Professional | UE · Used equipment | $154.88 | $162.18 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $549.54 | Facility | None | $54.95 | $54.95 | $549.54 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None (both parts) | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None (both parts) Typical Low $107.15 Median $144.54 Typical High $245.47 | Professional | None (both parts) | $107.15 | $144.54 | $245.47 |
United Setting Professional Modifier RR · Rental Typical Low $13.18 Median $19.50 Typical High $27.54 | Professional | RR · Rental | $13.18 | $19.50 | $27.54 |
United Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $109.65 Typical High $173.78 | Professional | UE · Used equipment | $79.43 | $109.65 | $173.78 |
Univera Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $281.84 | Facility | None | $257.04 | $257.04 | $281.84 |
Univera Setting Facility Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.90 | Facility | RR · Rental | $25.70 | $25.70 | $30.90 |
Univera Setting Professional Modifier None (both parts) Typical Low $257.04 Median $275.42 Typical High $302.00 | Professional | None (both parts) | $257.04 | $275.42 | $302.00 |
Univera Setting Professional Modifier RR · Rental Typical Low $23.44 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $23.44 | $25.70 | $30.20 |
Univera Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $162.18 Typical High $257.04 | Professional | UE · Used equipment | $154.88 | $162.18 | $257.04 |
9 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 $100.00 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $100.00 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $46.77 Typical High $63.10 | Professional | 26 · Professional part | $19.05 | $46.77 | $63.10 |
Excellus BCBS Setting Professional Modifier KH · Purchase or 1st rental month Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | KH · Purchase or 1st rental month | $23.44 | $23.44 | $23.44 |
Excellus BCBS Setting Professional Modifier RB · Replacement part Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | RB · Replacement part | $309.03 | $309.03 | $309.03 |
Univera Setting Professional Modifier KH · Purchase or 1st rental month Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | KH · Purchase or 1st rental month | $23.44 | $23.44 | $23.44 |
Univera Setting Professional Modifier RB · Replacement part Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | RB · Replacement part | $309.03 | $309.03 | $309.03 |
Where New York sits
The same service costs 22.4 times more in Kansas than in Illinois. 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· 12th of 51
$204
KS $447IL $19.95
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.