How much rates vary
Facilitymedian $12 · 10th to 90th $10 to $34Professionalmedian $11 · 10th to 90th $10 to $29
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 $6.76 Median $8.51 Typical High $12.30 | Facility | None | $6.76 | $8.51 | $12.30 |
Aetna Setting Professional Modifier None (both parts) Typical Low $8.51 Median $8.51 Typical High $12.30 | Professional | None (both parts) | $8.51 | $8.51 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $20.42 Typical High $39.81 | Facility | None | $19.95 | $20.42 | $39.81 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $11.48 Median $11.48 Typical High $34.67 | Professional | None (both parts) | $11.48 | $11.48 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $2.45 | Professional | RR · Rental | $1.15 | $1.15 | $2.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $17.38 | Professional | UE · Used equipment | $8.71 | $8.71 | $17.38 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None (both parts) | $16.22 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.45 | Facility | None | $13.49 | $13.49 | $14.45 |
Cigna Setting Professional Modifier None (both parts) Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None (both parts) | $9.77 | $9.77 | $9.77 |
Emblem Health Setting Facility Modifier None Typical Low $19.95 Median $33.11 Typical High $72.44 | Facility | None | $19.95 | $33.11 | $72.44 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $13.18 Median $21.38 Typical High $35.48 | Professional | None (both parts) | $13.18 | $21.38 | $35.48 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $10.00 Median $11.48 Typical High $16.22 | Professional | None (both parts) | $10.00 | $11.48 | $16.22 |
MVP Health Care Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $11.75 Median $11.75 Typical High $29.51 | Professional | None (both parts) | $11.75 | $11.75 | $29.51 |
United Setting Facility Modifier None Typical Low $7.94 Median $9.77 Typical High $32.36 | Facility | None | $7.94 | $9.77 | $32.36 |
United Setting Professional Modifier None (both parts) Typical Low $6.61 Median $10.47 Typical High $15.14 | Professional | None (both parts) | $6.61 | $10.47 | $15.14 |
Univera Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $12.02 | Facility | None | $10.00 | $10.00 | $12.02 |
Univera Setting Professional Modifier None (both parts) Typical Low $10.00 Median $11.48 Typical High $16.22 | Professional | None (both parts) | $10.00 | $11.48 | $16.22 |
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 $4.27 Median $4.27 Typical High $6.17 | Professional | 52 · Reduced service | $4.27 | $4.27 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $2.45 | Professional | 53 · Discontinued | $1.70 | $1.70 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.86 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $1.23 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $0.89 Median $1.32 Typical High $1.74 | Professional | 26 · Professional part | $0.89 | $1.32 | $1.74 |
Where New York sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 40th of 51
$11.48
AR $22.91KS $9.12
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.