How much rates vary
Facilitymedian $302 · 10th to 90th $282 to $513Professionalmedian $288 · 10th to 90th $209 to $575
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 $169.82 Median $208.93 Typical High $218.78 | Facility | None | $169.82 | $208.93 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | None | $208.93 | $208.93 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $562.34 | Facility | None | $281.84 | $288.40 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $831.76 | Professional | None | $281.84 | $281.84 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $63.10 | Professional | RR · Rental | $28.18 | $28.18 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $213.80 Typical High $380.19 | Professional | UE · Used equipment | $213.80 | $213.80 | $380.19 |
CDPHP Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $331.13 | Facility | None | $302.00 | $302.00 | $331.13 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | RR · Rental | $25.70 | $25.70 | $25.70 |
Emblem Health Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,023.29 | Facility | None | $281.84 | $457.09 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $501.19 | Professional | None | $181.97 | $302.00 | $501.19 |
Excellus BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | None | $288.40 | $302.00 | $323.59 |
Fidelis Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Highmark BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $489.78 | Professional | None | $302.00 | $302.00 | $489.78 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $645.65 | Facility | None | $489.78 | $489.78 | $645.65 |
United Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $346.74 | Professional | None | $162.18 | $251.19 | $346.74 |
Univera Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $309.03 | Facility | None | $288.40 | $288.40 | $309.03 |
Univera Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | None | $288.40 | $302.00 | $323.59 |
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 $104.71 Median $104.71 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.88 |
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· 17th of 51
$288
HI $490UT $191
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.