How much rates vary
Facilitymedian $380 · 10th to 90th $324 to $1,000Professionalmedian $355 · 10th to 90th $263 to $813
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 $199.53 Median $257.04 Typical High $371.54 | Facility | None | $199.53 | $257.04 | $371.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $257.04 Median $257.04 Typical High $371.54 | Professional | None (both parts) | $257.04 | $257.04 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $1,202.26 | Facility | None | $602.56 | $616.60 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $354.81 Median $363.08 Typical High $1,023.29 | Professional | None (both parts) | $354.81 | $363.08 | $1,023.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $75.86 | Professional | RR · Rental | $35.48 | $35.48 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $478.63 | Professional | UE · Used equipment | $263.03 | $263.03 | $478.63 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $616.60 | Facility | None | $380.19 | $380.19 | $616.60 |
Cigna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None (both parts) | $275.42 | $275.42 | $275.42 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $2,187.76 | Facility | None | $602.56 | $1,000.00 | $2,187.76 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $389.05 Median $630.96 Typical High $1,071.52 | Professional | None (both parts) | $389.05 | $630.96 | $1,071.52 |
Excellus BCBS Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $323.59 Median $338.84 Typical High $489.78 | Professional | None (both parts) | $323.59 | $338.84 | $489.78 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $870.96 | Professional | None (both parts) | $263.03 | $263.03 | $870.96 |
United Setting Facility Modifier None Typical Low $389.05 Median $467.74 Typical High $954.99 | Facility | None | $389.05 | $467.74 | $954.99 |
United Setting Professional Modifier None (both parts) Typical Low $194.98 Median $309.03 Typical High $446.68 | Professional | None (both parts) | $194.98 | $309.03 | $446.68 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Facility | None | $323.59 | $323.59 | $371.54 |
Univera Setting Professional Modifier None (both parts) Typical Low $323.59 Median $338.84 Typical High $489.78 | Professional | None (both parts) | $323.59 | $338.84 | $489.78 |
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 $128.82 Median $128.82 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $37.15 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $39.81 Typical High $51.29 | Professional | 26 · Professional part | $26.92 | $39.81 | $51.29 |
Where New York sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 38th of 51
$355
HI $1,023FL $275
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.