How much rates vary
Facilitymedian $36 · 10th to 90th $21 to $123Professionalmedian $42 · 10th to 90th $27 to $107
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 $25.12 Median $32.36 Typical High $46.77 | Facility | None | $25.12 | $32.36 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $77.62 Typical High $151.36 | Facility | None | $75.86 | $77.62 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $131.83 | Professional | None | $41.69 | $41.69 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $8.71 | Professional | RR · Rental | $4.07 | $4.07 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | UE · Used equipment | $30.20 | $30.20 | $53.70 |
CDPHP Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Facility | None | $36.31 | $36.31 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $269.15 | Facility | None | $75.86 | $123.03 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $131.83 | Professional | None | $48.98 | $79.43 | $131.83 |
Excellus BCBS Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $21.38 Median $42.66 Typical High $61.66 | Professional | None | $21.38 | $42.66 | $61.66 |
MVP Health Care Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
MVP Health Care Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $109.65 | Professional | None | $33.88 | $33.88 | $109.65 |
United Setting Facility Modifier None Typical Low $38.90 Median $91.20 Typical High $120.23 | Facility | None | $38.90 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $24.55 Median $38.90 Typical High $54.95 | Professional | None | $24.55 | $38.90 | $54.95 |
Univera Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $42.66 | Facility | None | $21.38 | $21.38 | $42.66 |
Univera Setting Professional Modifier None Typical Low $21.38 Median $42.66 Typical High $61.66 | Professional | None | $21.38 | $42.66 | $61.66 |
4 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 $16.22 Median $16.22 Typical High $23.44 | Professional | 52 · Reduced service | $16.22 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $9.33 | Professional | 53 · Discontinued | $6.46 | $6.46 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $6.92 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $4.68 |
Where New York sits
The same service costs 2.9 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· 24th of 51
$41.69
HI $91.20DE $31.62
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.