How much rates vary
Facilitymedian $39 · 10th to 90th $10 to $110Professionalmedian $37 · 10th to 90th $26 to $93
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 $21.38 Median $26.92 Typical High $38.90 | Facility | None | $21.38 | $26.92 | $38.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $26.92 Median $26.92 Typical High $38.90 | Professional | None (both parts) | $26.92 | $26.92 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $64.57 Typical High $125.89 | Facility | None | $63.10 | $64.57 | $125.89 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $109.65 | Professional | None (both parts) | $37.15 | $37.15 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $7.94 | Professional | RR · Rental | $3.72 | $3.72 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $50.12 | Professional | UE · Used equipment | $27.54 | $27.54 | $50.12 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $43.65 | Facility | None | $40.74 | $40.74 | $43.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None (both parts) | $29.51 | $29.51 | $29.51 |
Emblem Health Setting Facility Modifier None Typical Low $63.10 Median $104.71 Typical High $229.09 | Facility | None | $63.10 | $104.71 | $229.09 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $41.69 Median $67.61 Typical High $112.20 | Professional | None (both parts) | $41.69 | $67.61 | $112.20 |
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 $37.15 Typical High $52.48 | Professional | None (both parts) | $10.00 | $37.15 | $52.48 |
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 $37.15 Median $37.15 Typical High $93.33 | Professional | None (both parts) | $37.15 | $37.15 | $93.33 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $102.33 | Facility | None | $36.31 | $40.74 | $102.33 |
United Setting Professional Modifier None (both parts) Typical Low $20.89 Median $33.11 Typical High $47.86 | Professional | None (both parts) | $20.89 | $33.11 | $47.86 |
Univera Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $37.15 | Facility | None | $10.00 | $10.00 | $37.15 |
Univera Setting Professional Modifier None (both parts) Typical Low $10.00 Median $37.15 Typical High $52.48 | Professional | None (both parts) | $10.00 | $37.15 | $52.48 |
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 $13.49 Median $13.49 Typical High $19.50 | Professional | 52 · Reduced service | $13.49 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $7.94 | Professional | 53 · Discontinued | $5.37 | $5.37 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $5.89 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $3.89 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $2.88 Median $4.27 Typical High $5.50 | Professional | 26 · Professional part | $2.88 | $4.27 | $5.50 |
Where New York sits
The same service costs 2.7 times more in Montana 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· 43rd of 51
$37.15
MT $83.18DE $30.90
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.