How much rates vary
Facilitymedian $49 · 10th to 90th $35 to $145Professionalmedian $51 · 10th to 90th $35 to $120
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 $27.54 Median $35.48 Typical High $51.29 | Facility | None | $27.54 | $35.48 | $51.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | None (both parts) | $35.48 | $35.48 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $165.96 | Facility | None | $83.18 | $85.11 | $165.96 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $147.91 | Professional | None (both parts) | $51.29 | $51.29 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $10.72 | Professional | RR · Rental | $4.90 | $4.90 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $66.07 | Professional | UE · Used equipment | $37.15 | $37.15 | $66.07 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Facility | None | $61.66 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $44.67 | $44.67 | $44.67 |
Emblem Health Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $302.00 | Facility | None | $83.18 | $138.04 | $302.00 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $53.70 Median $87.10 Typical High $147.91 | Professional | None (both parts) | $53.70 | $87.10 | $147.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $35.48 Median $48.98 Typical High $67.61 | Professional | None (both parts) | $35.48 | $48.98 | $67.61 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $120.23 | Professional | None (both parts) | $48.98 | $48.98 | $120.23 |
United Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $131.83 | Facility | None | $41.69 | $45.71 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $26.92 Median $42.66 Typical High $61.66 | Professional | None (both parts) | $26.92 | $42.66 | $61.66 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Facility | None | $35.48 | $35.48 | $48.98 |
Univera Setting Professional Modifier None (both parts) Typical Low $35.48 Median $48.98 Typical High $67.61 | Professional | None (both parts) | $35.48 | $48.98 | $67.61 |
6 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 $17.78 Median $17.78 Typical High $25.70 | Professional | 52 · Reduced service | $17.78 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $10.23 | Professional | 53 · Discontinued | $7.08 | $7.08 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $7.76 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $3.72 Median $5.50 Typical High $7.08 | Professional | 26 · Professional part | $3.72 | $5.50 | $7.08 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | KX · Policy requirements met | $66.07 | $66.07 | $66.07 |
Where New York sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 40th of 51
$51.29
HI $112AZ $44.67
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.