How much rates vary
Facilitymedian $100 · 10th to 90th $87 to $295Professionalmedian $100 · 10th to 90th $69 to $245
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 $58.88 Median $75.86 Typical High $109.65 | Facility | None | $58.88 | $75.86 | $109.65 |
Aetna Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | None (both parts) | $75.86 | $75.86 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $354.81 | Facility | None | $177.83 | $181.97 | $354.81 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $302.00 | Professional | None (both parts) | $83.18 | $83.18 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $18.20 | Professional | RR · Rental | $8.32 | $8.32 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $125.89 | Professional | UE · Used equipment | $63.10 | $63.10 | $125.89 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None (both parts) | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $95.50 | Facility | None | $87.10 | $87.10 | $95.50 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None (both parts) | $63.10 | $63.10 | $63.10 |
Emblem Health Setting Facility Modifier None Typical Low $177.83 Median $295.12 Typical High $645.65 | Facility | None | $177.83 | $295.12 | $645.65 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $114.82 Median $177.83 Typical High $316.23 | Professional | None (both parts) | $114.82 | $177.83 | $316.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $100.00 Median $104.71 Typical High $144.54 | Professional | None (both parts) | $100.00 | $104.71 | $144.54 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None (both parts) | $141.25 | $141.25 | $141.25 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $257.04 | Professional | None (both parts) | $104.71 | $104.71 | $257.04 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $223.87 | Facility | None | $39.81 | $69.18 | $223.87 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $91.20 Typical High $123.03 | Professional | None (both parts) | $57.54 | $91.20 | $123.03 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
Univera Setting Professional Modifier None (both parts) Typical Low $100.00 Median $104.71 Typical High $144.54 | Professional | None (both parts) | $100.00 | $104.71 | $144.54 |
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 $38.02 Median $38.02 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | 53 · Discontinued | $15.14 | $15.14 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $10.96 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $11.75 Typical High $15.14 | Professional | 26 · Professional part | $7.76 | $11.75 | $15.14 |
Where New York sits
The same service costs 2.5 times more in Arkansas 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· 19th of 51
$100
AR $158FL $64.57
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.