How much rates vary
Facilitymedian $126 · 10th to 90th $79 to $363Professionalmedian $123 · 10th to 90th $85 to $302
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 $69.18 Median $87.10 Typical High $125.89 | Facility | None | $69.18 | $87.10 | $125.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $87.10 Median $87.10 Typical High $125.89 | Professional | None (both parts) | $87.10 | $87.10 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $208.93 Typical High $407.38 | Facility | None | $204.17 | $208.93 | $407.38 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $123.03 Median $123.03 Typical High $363.08 | Professional | None (both parts) | $123.03 | $123.03 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $26.30 | Professional | RR · Rental | $12.30 | $12.30 | $26.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $91.20 Typical High $165.96 | Professional | UE · Used equipment | $91.20 | $91.20 | $165.96 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None (both parts) | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Facility | None | $134.90 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $338.84 Typical High $741.31 | Facility | None | $204.17 | $338.84 | $741.31 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $134.90 Median $218.78 Typical High $363.08 | Professional | None (both parts) | $134.90 | $218.78 | $363.08 |
Excellus BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $79.43 Median $120.23 Typical High $169.82 | Professional | None (both parts) | $79.43 | $120.23 | $169.82 |
MVP Health Care Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $302.00 | Professional | None (both parts) | $120.23 | $120.23 | $302.00 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $331.13 | Facility | None | $63.10 | $128.82 | $331.13 |
United Setting Professional Modifier None (both parts) Typical Low $67.61 Median $107.15 Typical High $154.88 | Professional | None (both parts) | $67.61 | $107.15 | $154.88 |
Univera Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $120.23 | Facility | None | $79.43 | $79.43 | $120.23 |
Univera Setting Professional Modifier None (both parts) Typical Low $79.43 Median $120.23 Typical High $169.82 | Professional | None (both parts) | $79.43 | $120.23 | $169.82 |
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 $43.65 Median $43.65 Typical High $63.10 | Professional | 52 · Reduced service | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $17.38 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.59 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $9.33 Median $13.49 Typical High $17.78 | Professional | 26 · Professional part | $9.33 | $13.49 | $17.78 |
Where New York sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 35th of 51
$123
KS $389NJ $100
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.