How much rates vary
Facilitymedian $1,288 · 10th to 90th $933 to $2,884Professionalmedian $1,000 · 10th to 90th $724 to $2,399
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 $562.34 Median $724.44 Typical High $1,047.13 | Facility | None | $562.34 | $724.44 | $1,047.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $724.44 Median $724.44 Typical High $1,047.13 | Professional | None (both parts) | $724.44 | $724.44 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,388.44 | Facility | None | $1,698.24 | $1,698.24 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $912.01 Median $912.01 Typical High $2,951.21 | Professional | None (both parts) | $912.01 | $912.01 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $199.53 | Professional | RR · Rental | $91.20 | $91.20 | $199.53 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $691.83 Median $691.83 Typical High $1,230.27 | Professional | UE · Used equipment | $691.83 | $691.83 | $1,230.27 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None (both parts) | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Facility | None | $933.25 | $933.25 | $1,000.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None (both parts) | $691.83 | $691.83 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,754.23 Typical High $6,025.60 | Facility | None | $1,698.24 | $2,754.23 | $6,025.60 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $1,778.28 Typical High $2,951.21 | Professional | None (both parts) | $1,096.48 | $1,778.28 | $2,951.21 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,288.25 Typical High $1,380.38 | Professional | None (both parts) | $1,000.00 | $1,288.25 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $1,023.29 Median $1,023.29 Typical High $2,454.71 | Professional | None (both parts) | $1,023.29 | $1,023.29 | $2,454.71 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,691.53 | Facility | None | $2,041.74 | $2,041.74 | $2,691.53 |
United Setting Professional Modifier None (both parts) Typical Low $549.54 Median $870.96 Typical High $1,202.26 | Professional | None (both parts) | $549.54 | $870.96 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,000.00 | $1,288.25 | $1,288.25 |
Univera Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,288.25 Typical High $1,380.38 | Professional | None (both parts) | $1,000.00 | $1,288.25 | $1,380.38 |
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 $354.81 Median $354.81 Typical High $524.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $104.71 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $10.96 Median $12.88 Typical High $14.45 | Professional | 26 · Professional part | $10.96 | $12.88 | $14.45 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 24th of 51
$1,000
HI $1,778DE $692
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.