How much rates vary
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 $831.76 Median $1,047.13 Typical High $1,548.82 | Facility | None | $831.76 | $1,047.13 | $1,548.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,047.13 Typical High $1,548.82 | Professional | None (both parts) | $1,047.13 | $1,047.13 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $5,011.87 | Facility | None | $2,454.71 | $2,511.89 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,479.11 Typical High $4,365.16 | Professional | None (both parts) | $1,479.11 | $1,479.11 | $4,365.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $147.91 Typical High $316.23 | Professional | RR · Rental | $147.91 | $147.91 | $316.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $1,122.02 Typical High $1,995.26 | Professional | UE · Used equipment | $1,122.02 | $1,122.02 | $1,995.26 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None (both parts) | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,737.80 | Facility | None | $1,621.81 | $1,621.81 | $1,737.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None (both parts) | $1,202.26 | $1,202.26 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $2,454.71 Median $4,073.80 Typical High $8,912.51 | Facility | None | $2,454.71 | $4,073.80 | $8,912.51 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,630.27 Typical High $4,365.16 | Professional | None (both parts) | $1,621.81 | $2,630.27 | $4,365.16 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,479.11 Typical High $2,041.74 | Professional | None (both parts) | $1,318.26 | $1,479.11 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $1,445.44 Typical High $3,630.78 | Professional | None (both parts) | $1,445.44 | $1,445.44 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $3,981.07 | Facility | None | $1,479.11 | $1,513.56 | $3,981.07 |
United Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,288.25 Typical High $1,862.09 | Professional | None (both parts) | $812.83 | $1,288.25 | $1,862.09 |
Univera Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Facility | None | $1,318.26 | $1,318.26 | $1,513.56 |
Univera Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,479.11 Typical High $2,041.74 | Professional | None (both parts) | $1,318.26 | $1,479.11 | $2,041.74 |
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 $524.81 Median $524.81 Typical High $758.58 | Professional | 52 · Reduced service | $524.81 | $524.81 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $309.03 | Professional | 53 · Discontinued | $213.80 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $154.88 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $165.96 Typical High $213.80 | Professional | 26 · Professional part | $112.20 | $165.96 | $213.80 |
Where New York sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 32nd of 51
$1,479
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.