How much rates vary
Facilitymedian $55 · 10th to 90th $30 to $158Professionalmedian $54 · 10th to 90th $37 to $129
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 $30.20 Median $38.02 Typical High $54.95 | Facility | None | $30.20 | $38.02 | $54.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | None (both parts) | $38.02 | $38.02 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $177.83 | Facility | None | $89.13 | $91.20 | $177.83 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $158.49 | Professional | None (both parts) | $53.70 | $53.70 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $11.22 | Professional | RR · Rental | $5.25 | $5.25 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $70.79 | Professional | UE · Used equipment | $39.81 | $39.81 | $70.79 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $323.59 | Facility | None | $89.13 | $147.91 | $323.59 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $58.88 Median $89.13 Typical High $158.49 | Professional | None (both parts) | $58.88 | $89.13 | $158.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $30.20 Median $52.48 Typical High $72.44 | Professional | None (both parts) | $30.20 | $52.48 | $72.44 |
MVP Health Care Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $131.83 | Professional | None (both parts) | $52.48 | $52.48 | $131.83 |
United Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $144.54 | Facility | None | $47.86 | $58.88 | $144.54 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $46.77 Typical High $67.61 | Professional | None (both parts) | $29.51 | $46.77 | $67.61 |
Univera Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $52.48 | Facility | None | $30.20 | $30.20 | $52.48 |
Univera Setting Professional Modifier None (both parts) Typical Low $30.20 Median $52.48 Typical High $72.44 | Professional | None (both parts) | $30.20 | $52.48 | $72.44 |
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 $19.05 Median $19.05 Typical High $27.54 | Professional | 52 · Reduced service | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | 53 · Discontinued | $7.59 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $8.32 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $5.50 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.07 Median $5.89 Typical High $7.76 | Professional | 26 · Professional part | $4.07 | $5.89 | $7.76 |
Where New York sits
The same service costs 3.4 times more in Hawaii 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· 37th of 51
$53.70
HI $166VT $48.98
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.