How much rates vary
Facilitymedian $813 · 10th to 90th $741 to $1,445Professionalmedian $741 · 10th to 90th $550 to $1,479
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 $446.68 Median $549.54 Typical High $616.60 | Facility | None | $446.68 | $549.54 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,348.96 | Professional | None | $549.54 | $549.54 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $1,621.81 | Facility | None | $812.83 | $831.76 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,187.76 | Professional | None | $741.31 | $741.31 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $74.13 Median $74.13 Typical High $162.18 | Professional | RR · Rental | $74.13 | $74.13 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $562.34 Median $562.34 Typical High $1,000.00 | Professional | UE · Used equipment | $562.34 | $562.34 | $1,000.00 |
CDPHP Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
Cigna Setting Facility Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | RR · Rental | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | RR · Rental | $69.18 | $69.18 | $69.18 |
Emblem Health Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $2,951.21 | Facility | None | $812.83 | $1,348.96 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,445.44 | Professional | None | $524.81 | $851.14 | $1,445.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | None | $741.31 | $794.33 | $851.14 |
Highmark BCBS Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,412.54 | Professional | None | $776.25 | $776.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,862.09 | Facility | None | $1,445.44 | $1,445.44 | $1,862.09 |
United Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $954.99 | Professional | None | $416.87 | $676.08 | $954.99 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $794.33 | Facility | None | $741.31 | $741.31 | $794.33 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | None | $741.31 | $794.33 | $851.14 |
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 $275.42 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Fidelis Setting Professional Modifier KX · Policy requirements met Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | KX · Policy requirements met | $501.19 | $501.19 | $501.19 |
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· 33rd of 51
$741
HI $1,445UT $550
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.