How much rates vary
Facilitymedian $209 · 10th to 90th $178 to $501Professionalmedian $174 · 10th to 90th $141 to $427
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 $97.72 Median $125.89 Typical High $181.97 | Facility | None | $97.72 | $125.89 | $181.97 |
Aetna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None (both parts) | $125.89 | $125.89 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $588.84 | Facility | None | $295.12 | $302.00 | $588.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $173.78 Median $173.78 Typical High $512.86 | Professional | None (both parts) | $173.78 | $173.78 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $38.02 | Professional | RR · Rental | $17.38 | $17.38 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $234.42 | Professional | UE · Used equipment | $131.83 | $131.83 | $234.42 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None (both parts) | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $239.88 | Facility | None | $223.87 | $223.87 | $239.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None (both parts) | $165.96 | $165.96 | $165.96 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | None | $295.12 | $489.78 | $1,071.52 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $190.55 Median $309.03 Typical High $524.81 | Professional | None (both parts) | $190.55 | $309.03 | $524.81 |
Excellus BCBS Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $173.78 Median $181.97 Typical High $239.88 | Professional | None (both parts) | $173.78 | $181.97 | $239.88 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $169.82 Median $169.82 Typical High $426.58 | Professional | None (both parts) | $169.82 | $169.82 | $426.58 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $467.74 | Facility | None | $190.55 | $208.93 | $467.74 |
United Setting Professional Modifier None (both parts) Typical Low $95.50 Median $151.36 Typical High $218.78 | Professional | None (both parts) | $95.50 | $151.36 | $218.78 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $181.97 Typical High $181.97 | Facility | None | $173.78 | $181.97 | $181.97 |
Univera Setting Professional Modifier None (both parts) Typical Low $173.78 Median $181.97 Typical High $239.88 | Professional | None (both parts) | $173.78 | $181.97 | $239.88 |
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 $63.10 Median $63.10 Typical High $91.20 | Professional | 52 · Reduced service | $63.10 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $36.31 | Professional | 53 · Discontinued | $25.12 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $18.20 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $13.18 Median $19.50 Typical High $25.12 | Professional | 26 · Professional part | $13.18 | $19.50 | $25.12 |
Where New York sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 34th of 51
$174
HI $525DC $155
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.