How much rates vary
Facilitymedian $240 · 10th to 90th $191 to $676Professionalmedian $234 · 10th to 90th $148 to $550
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 $134.90 Median $169.82 Typical High $245.47 | Facility | None | $134.90 | $169.82 | $245.47 |
Aetna Setting Professional Modifier None (both parts) Typical Low $169.82 Median $169.82 Typical High $245.47 | Professional | None (both parts) | $169.82 | $169.82 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $794.33 | Facility | None | $398.11 | $407.38 | $794.33 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $676.08 | Professional | None (both parts) | $181.97 | $181.97 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $38.02 | Professional | RR · Rental | $17.78 | $17.78 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $239.88 | Professional | UE · Used equipment | $131.83 | $131.83 | $239.88 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None (both parts) | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $213.80 | Facility | None | $190.55 | $190.55 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None (both parts) | $138.04 | $138.04 | $138.04 |
Emblem Health Setting Facility Modifier None Typical Low $398.11 Median $660.69 Typical High $1,445.44 | Facility | None | $398.11 | $660.69 | $1,445.44 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $263.03 Median $398.11 Typical High $707.95 | Professional | None (both parts) | $263.03 | $398.11 | $707.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $234.42 Median $239.88 Typical High $331.13 | Professional | None (both parts) | $234.42 | $239.88 | $331.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None (both parts) | $316.23 | $316.23 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $588.84 | Professional | None (both parts) | $281.84 | $281.84 | $588.84 |
United Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $478.63 | Facility | None | $190.55 | $194.98 | $478.63 |
United Setting Professional Modifier None (both parts) Typical Low $131.83 Median $208.93 Typical High $275.42 | Professional | None (both parts) | $131.83 | $208.93 | $275.42 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $245.47 | Facility | None | $234.42 | $239.88 | $245.47 |
Univera Setting Professional Modifier None (both parts) Typical Low $234.42 Median $239.88 Typical High $331.13 | Professional | None (both parts) | $234.42 | $239.88 | $331.13 |
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 $85.11 Median $85.11 Typical High $123.03 | Professional | 52 · Reduced service | $85.11 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $24.55 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $26.30 Typical High $34.67 | Professional | 26 · Professional part | $18.20 | $26.30 | $34.67 |
Where New York sits
The same service costs 3.5 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· 15th of 51
$234
HI $479FL $138
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.