How much rates vary
Facilitymedian $76 · 10th to 90th $41 to $214Professionalmedian $74 · 10th to 90th $49 to $186
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 $43.65 Median $56.23 Typical High $81.28 | Facility | None | $43.65 | $56.23 | $81.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $56.23 Typical High $81.28 | Professional | None (both parts) | $56.23 | $56.23 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $263.03 | Facility | None | $131.83 | $134.90 | $263.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $229.09 | Professional | None (both parts) | $70.79 | $70.79 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | RR · Rental | $7.08 | $7.08 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $95.50 | Professional | UE · Used equipment | $52.48 | $52.48 | $95.50 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Facility | None | $75.86 | $75.86 | $81.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $54.95 | $54.95 | $54.95 |
Emblem Health Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $478.63 | Facility | None | $131.83 | $213.80 | $478.63 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $85.11 Median $138.04 Typical High $234.42 | Professional | None (both parts) | $85.11 | $138.04 | $234.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $40.74 Median $77.62 Typical High $107.15 | Professional | None (both parts) | $40.74 | $77.62 | $107.15 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $190.55 | Professional | None (both parts) | $75.86 | $75.86 | $190.55 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $190.55 | Facility | None | $77.62 | $87.10 | $190.55 |
United Setting Professional Modifier None (both parts) Typical Low $42.66 Median $67.61 Typical High $93.33 | Professional | None (both parts) | $42.66 | $67.61 | $93.33 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $77.62 | Facility | None | $40.74 | $40.74 | $77.62 |
Univera Setting Professional Modifier None (both parts) Typical Low $40.74 Median $77.62 Typical High $107.15 | Professional | None (both parts) | $40.74 | $77.62 | $107.15 |
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 $28.18 Median $28.18 Typical High $40.74 | Professional | 52 · Reduced service | $28.18 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $16.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $8.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $6.03 Median $8.71 Typical High $11.22 | Professional | 26 · Professional part | $6.03 | $8.71 | $11.22 |
Where New York sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 30th of 51
$74.13
KS $245VT $56.23
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.