How much rates vary
Facilitymedian $209 · 10th to 90th $195 to $355Professionalmedian $200 · 10th to 90th $148 to $398
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 $120.23 Median $147.91 Typical High $151.36 | Facility | None | $120.23 | $147.91 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $389.05 | Facility | None | $194.98 | $199.53 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $588.84 | Professional | None | $194.98 | $194.98 | $588.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $41.69 | Professional | RR · Rental | $19.50 | $19.50 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $257.04 | Professional | UE · Used equipment | $144.54 | $144.54 | $257.04 |
CDPHP Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Facility | None | $213.80 | $213.80 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Emblem Health Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $707.95 | Facility | None | $194.98 | $323.59 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $346.74 | Professional | None | $125.89 | $204.17 | $346.74 |
Excellus BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $229.09 | Professional | None | $199.53 | $208.93 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
MVP Health Care Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $338.84 | Professional | None | $208.93 | $208.93 | $338.84 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $446.68 | Facility | None | $346.74 | $346.74 | $446.68 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $245.47 | Professional | None | $112.20 | $173.78 | $245.47 |
Univera Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Facility | None | $199.53 | $199.53 | $213.80 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $229.09 | Professional | None | $199.53 | $208.93 | $229.09 |
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 $74.13 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.14 |
Highmark BCBS Setting Professional Modifier CG · Policy criteria applied Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | CG · Policy criteria applied | $213.80 | $213.80 | $213.80 |
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· 13th of 51
$200
HI $347UT $132
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.