How much rates vary
Facilitymedian $58 · 10th to 90th $41 to $155Professionalmedian $54 · 10th to 90th $41 to $129
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 $29.51 Median $38.02 Typical High $54.95 | Facility | None | $29.51 | $38.02 | $54.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | None (both parts) | $38.02 | $38.02 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $177.83 | Facility | None | $89.13 | $91.20 | $177.83 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $158.49 | Professional | None (both parts) | $53.70 | $53.70 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $11.22 | Professional | RR · Rental | $5.25 | $5.25 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $70.79 | Professional | UE · Used equipment | $39.81 | $39.81 | $70.79 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None (both parts) | $46.77 | $46.77 | $46.77 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $323.59 | Facility | None | $89.13 | $147.91 | $323.59 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $57.54 Median $95.50 Typical High $158.49 | Professional | None (both parts) | $57.54 | $95.50 | $158.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $40.74 Median $52.48 Typical High $72.44 | Professional | None (both parts) | $40.74 | $52.48 | $72.44 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $128.82 | Professional | None (both parts) | $52.48 | $52.48 | $128.82 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $141.25 | Facility | None | $57.54 | $60.26 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $28.84 Median $45.71 Typical High $66.07 | Professional | None (both parts) | $28.84 | $45.71 | $66.07 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
Univera Setting Professional Modifier None (both parts) Typical Low $40.74 Median $52.48 Typical High $72.44 | Professional | None (both parts) | $40.74 | $52.48 | $72.44 |
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 $19.05 Median $19.05 Typical High $27.54 | Professional | 52 · Reduced service | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | 53 · Discontinued | $7.59 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $8.32 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $5.50 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $3.98 Median $5.89 Typical High $7.59 | Professional | 26 · Professional part | $3.98 | $5.89 | $7.59 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | KX · Policy requirements met | $70.79 | $70.79 | $70.79 |
Where New York sits
The same service costs 3.5 times more in Hawaii than in New Jersey. 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· 33rd of 51
$53.70
HI $166NJ $46.77
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.