How much rates vary
Facilitymedian $141 · 10th to 90th $89 to $316Professionalmedian $112 · 10th to 90th $71 to $263
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 $63.10 Median $81.28 Typical High $117.49 | Facility | None | $63.10 | $81.28 | $117.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | None (both parts) | $81.28 | $81.28 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $380.19 | Facility | None | $190.55 | $194.98 | $380.19 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $323.59 | Professional | None (both parts) | $83.18 | $83.18 | $323.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $18.20 | Professional | RR · Rental | $8.32 | $8.32 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $112.20 | Professional | UE · Used equipment | $63.10 | $63.10 | $112.20 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None (both parts) | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Facility | None | $89.13 | $89.13 | $97.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None (both parts) | $64.57 | $64.57 | $64.57 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $691.83 | Facility | None | $190.55 | $316.23 | $691.83 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $123.03 Median $190.55 Typical High $338.84 | Professional | None (both parts) | $123.03 | $190.55 | $338.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $112.20 Median $141.25 Typical High $154.88 | Professional | None (both parts) | $112.20 | $141.25 | $154.88 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $281.84 | Professional | None (both parts) | $112.20 | $112.20 | $281.84 |
United Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $229.09 | Facility | None | $70.79 | $87.10 | $229.09 |
United Setting Professional Modifier None (both parts) Typical Low $61.66 Median $100.00 Typical High $131.83 | Professional | None (both parts) | $61.66 | $100.00 | $131.83 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Facility | None | $112.20 | $141.25 | $141.25 |
Univera Setting Professional Modifier None (both parts) Typical Low $112.20 Median $141.25 Typical High $154.88 | Professional | None (both parts) | $112.20 | $141.25 | $154.88 |
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 $40.74 Median $40.74 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $23.44 | Professional | 53 · Discontinued | $16.22 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $11.75 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $8.32 Median $12.59 Typical High $16.60 | Professional | 26 · Professional part | $8.32 | $12.59 | $16.60 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Florida. 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· 17th of 51
$112
HI $186FL $70.79
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.