How much rates vary
Facilitymedian $257 · 10th to 90th $234 to $437Professionalmedian $240 · 10th to 90th $178 to $490
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 $144.54 Median $177.83 Typical High $186.21 | Facility | None | $144.54 | $177.83 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | None | $177.83 | $177.83 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $467.74 | Facility | None | $234.42 | $239.88 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $707.95 | Professional | None | $239.88 | $239.88 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $54.95 | Professional | RR · Rental | $23.99 | $23.99 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $323.59 | Professional | UE · Used equipment | $177.83 | $177.83 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Facility | None | $275.42 | $275.42 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $851.14 | Facility | None | $234.42 | $389.05 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $416.87 | Professional | None | $154.88 | $245.47 | $416.87 |
Excellus BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | None | $239.88 | $251.19 | $275.42 |
MVP Health Care Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | None | $251.19 | $251.19 | $416.87 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $537.03 | Facility | None | $416.87 | $416.87 | $537.03 |
United Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $295.12 | Professional | None | $134.90 | $213.80 | $295.12 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Facility | None | $239.88 | $239.88 | $257.04 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | None | $239.88 | $251.19 | $275.42 |
4 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 $89.13 Median $89.13 Typical High $93.33 | Professional | 52 · Reduced service | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | 53 · Discontinued | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $27.54 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $18.62 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 21st of 51
$240
HI $417UT $162
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.