How much rates vary
Facilitymedian $282 · 10th to 90th $234 to $776Professionalmedian $263 · 10th to 90th $200 to $692
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 $154.88 Median $199.53 Typical High $288.40 | Facility | None | $154.88 | $199.53 | $288.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $794.33 | Professional | None (both parts) | $199.53 | $199.53 | $794.33 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None (both parts) | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $478.63 Typical High $933.25 | Facility | None | $467.74 | $478.63 | $933.25 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $812.83 | Professional | None (both parts) | $263.03 | $263.03 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $54.95 | Professional | RR · Rental | $25.12 | $25.12 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $338.84 | Professional | UE · Used equipment | $190.55 | $190.55 | $338.84 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None (both parts) | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None (both parts) | $229.09 | $229.09 | $229.09 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $1,698.24 | Facility | None | $467.74 | $776.25 | $1,698.24 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $302.00 Median $489.78 Typical High $831.76 | Professional | None (both parts) | $302.00 | $489.78 | $831.76 |
Excellus BCBS Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $234.42 Median $263.03 Typical High $380.19 | Professional | None (both parts) | $234.42 | $263.03 | $380.19 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None (both parts) | $371.54 | $371.54 | $371.54 |
MVP Health Care Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $676.08 | Professional | None (both parts) | $269.15 | $269.15 | $676.08 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $676.08 | Facility | None | $245.47 | $269.15 | $676.08 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $239.88 Typical High $331.13 | Professional | None (both parts) | $151.36 | $239.88 | $331.13 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
Univera Setting Professional Modifier None (both parts) Typical Low $234.42 Median $263.03 Typical High $380.19 | Professional | None (both parts) | $234.42 | $263.03 | $380.19 |
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 $100.00 Median $100.00 Typical High $144.54 | Professional | 52 · Reduced service | $100.00 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | 53 · Discontinued | $39.81 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $28.84 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $20.89 Median $30.90 Typical High $39.81 | Professional | 26 · Professional part | $20.89 | $30.90 | $39.81 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 34th of 51
$263
HI $589AZ $229
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.