How much rates vary
Facilitymedian $55 · 10th to 90th $52 to $98Professionalmedian $55 · 10th to 90th $40 to $110
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 $32.36 Median $39.81 Typical High $41.69 | Facility | None | $32.36 | $39.81 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | None | $39.81 | $39.81 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $107.15 | Facility | None | $53.70 | $53.70 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $158.49 | Professional | None | $53.70 | $53.70 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $12.02 | Professional | RR · Rental | $5.37 | $5.37 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $72.44 | Professional | UE · Used equipment | $40.74 | $40.74 | $72.44 |
CDPHP Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Facility | None | $52.48 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Emblem Health Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $190.55 | Facility | None | $53.70 | $87.10 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $93.33 | Professional | None | $34.67 | $56.23 | $93.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $61.66 | Professional | None | $54.95 | $56.23 | $61.66 |
MVP Health Care Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
MVP Health Care Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | None | $56.23 | $56.23 | $93.33 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $123.03 | Facility | None | $93.33 | $93.33 | $123.03 |
United Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $66.07 | Professional | None | $30.20 | $47.86 | $66.07 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Facility | None | $54.95 | $54.95 | $57.54 |
Univera Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $61.66 | Professional | None | $54.95 | $56.23 | $61.66 |
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 $19.95 Median $19.95 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.17 |
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· 14th of 51
$54.95
HI $93.33UT $36.31
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.