How much rates vary
Facilitymedian $78 · 10th to 90th $74 to $234Professionalmedian $79 · 10th to 90th $60 to $200
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 $47.86 Median $60.26 Typical High $87.10 | Facility | None | $47.86 | $60.26 | $87.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | None (both parts) | $60.26 | $60.26 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $281.84 | Facility | None | $141.25 | $144.54 | $281.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $245.47 | Professional | None (both parts) | $75.86 | $75.86 | $245.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $15.85 | Professional | RR · Rental | $7.41 | $7.41 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $100.00 | Professional | UE · Used equipment | $54.95 | $54.95 | $100.00 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None (both parts) | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | None (both parts) | $56.23 | $56.23 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $512.86 | Facility | None | $141.25 | $234.42 | $512.86 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $93.33 Median $141.25 Typical High $251.19 | Professional | None (both parts) | $93.33 | $141.25 | $251.19 |
Excellus BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $74.13 Median $83.18 Typical High $114.82 | Professional | None (both parts) | $74.13 | $83.18 | $114.82 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $208.93 | Professional | None (both parts) | $83.18 | $83.18 | $208.93 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $199.53 | Facility | None | $60.26 | $81.28 | $199.53 |
United Setting Professional Modifier None (both parts) Typical Low $46.77 Median $74.13 Typical High $100.00 | Professional | None (both parts) | $46.77 | $74.13 | $100.00 |
Univera Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $87.10 | Facility | None | $74.13 | $74.13 | $87.10 |
Univera Setting Professional Modifier None (both parts) Typical Low $74.13 Median $83.18 Typical High $114.82 | Professional | None (both parts) | $74.13 | $83.18 | $114.82 |
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 $30.20 Median $30.20 Typical High $43.65 | Professional | 52 · Reduced service | $30.20 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | 53 · Discontinued | $12.02 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $13.18 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $8.71 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $6.17 Median $9.33 Typical High $12.30 | Professional | 26 · Professional part | $6.17 | $9.33 | $12.30 |
Where New York sits
The same service costs 3.1 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· 27th of 51
$79.43
HI $174DE $56.23
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.