How much rates vary
Facilitymedian $398 · 10th to 90th $363 to $1,445Professionalmedian $427 · 10th to 90th $363 to $1,096
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 $288.40 Median $371.54 Typical High $537.03 | Facility | None | $288.40 | $371.54 | $537.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | None (both parts) | $371.54 | $371.54 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $891.25 Typical High $1,737.80 | Facility | None | $870.96 | $891.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $371.54 Median $389.05 Typical High $1,479.11 | Professional | None (both parts) | $371.54 | $389.05 | $1,479.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $81.28 | Professional | RR · Rental | $37.15 | $37.15 | $81.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $501.19 | Professional | UE · Used equipment | $281.84 | $281.84 | $501.19 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None (both parts) | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Facility | None | $398.11 | $398.11 | $426.58 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $295.12 | $295.12 | $295.12 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $3,162.28 | Facility | None | $870.96 | $1,445.44 | $3,162.28 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $562.34 Median $870.96 Typical High $1,548.82 | Professional | None (both parts) | $562.34 | $870.96 | $1,548.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $363.08 Median $512.86 Typical High $707.95 | Professional | None (both parts) | $363.08 | $512.86 | $707.95 |
MVP Health Care Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $512.86 Median $512.86 Typical High $1,258.93 | Professional | None (both parts) | $512.86 | $512.86 | $1,258.93 |
United Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $1,047.13 | Facility | None | $295.12 | $331.13 | $1,047.13 |
United Setting Professional Modifier None (both parts) Typical Low $281.84 Median $446.68 Typical High $602.56 | Professional | None (both parts) | $281.84 | $446.68 | $602.56 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $512.86 | Facility | None | $363.08 | $363.08 | $512.86 |
Univera Setting Professional Modifier None (both parts) Typical Low $363.08 Median $512.86 Typical High $707.95 | Professional | None (both parts) | $363.08 | $512.86 | $707.95 |
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 $186.21 Median $186.21 Typical High $269.15 | Professional | 52 · Reduced service | $186.21 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $53.70 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $57.54 Typical High $74.13 | Professional | 26 · Professional part | $38.90 | $57.54 | $74.13 |
Where New York sits
The same service costs 3.0 times more in Montana 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· 20th of 51
$417
MT $871FL $295
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.