How much rates vary
Facilitymedian $100 · 10th to 90th $76 to $282Professionalmedian $98 · 10th to 90th $74 to $245
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 $56.23 Median $72.44 Typical High $104.71 | Facility | None | $56.23 | $72.44 | $104.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | None (both parts) | $72.44 | $72.44 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $338.84 | Facility | None | $169.82 | $173.78 | $338.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $97.72 Median $97.72 Typical High $295.12 | Professional | None (both parts) | $97.72 | $97.72 | $295.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $20.42 | Professional | RR · Rental | $9.33 | $9.33 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $70.79 Typical High $125.89 | Professional | UE · Used equipment | $70.79 | $70.79 | $125.89 |
CDPHP 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 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $281.84 Typical High $616.60 | Facility | None | $169.82 | $281.84 | $616.60 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $109.65 Median $177.83 Typical High $302.00 | Professional | None (both parts) | $109.65 | $177.83 | $302.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $75.86 Median $100.00 Typical High $138.04 | Professional | None (both parts) | $75.86 | $100.00 | $138.04 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None (both parts) | $134.90 | $134.90 | $134.90 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $251.19 | Professional | None (both parts) | $100.00 | $100.00 | $251.19 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $245.47 | Facility | None | $93.33 | $93.33 | $245.47 |
United Setting Professional Modifier None (both parts) Typical Low $54.95 Median $89.13 Typical High $120.23 | Professional | None (both parts) | $54.95 | $89.13 | $120.23 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $100.00 | Facility | None | $75.86 | $75.86 | $100.00 |
Univera Setting Professional Modifier None (both parts) Typical Low $75.86 Median $100.00 Typical High $138.04 | Professional | None (both parts) | $75.86 | $100.00 | $138.04 |
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 $36.31 Median $36.31 Typical High $52.48 | Professional | 52 · Reduced service | $36.31 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $20.89 | Professional | 53 · Discontinued | $14.45 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $10.47 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $10.47 Typical High $14.79 | Professional | 26 · Professional part | $7.76 | $10.47 | $14.79 |
Where New York sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 32nd of 51
$97.72
HI $204CO $85.11
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.