How much rates vary
Facilitymedian $158 · 10th to 90th $95 to $457Professionalmedian $162 · 10th to 90th $110 to $389
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 $89.13 Median $114.82 Typical High $165.96 | Facility | None | $89.13 | $114.82 | $165.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | None (both parts) | $114.82 | $114.82 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $537.03 | Facility | None | $263.03 | $269.15 | $537.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $478.63 | Professional | None (both parts) | $162.18 | $162.18 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $33.88 | Professional | RR · Rental | $15.85 | $15.85 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $213.80 | Professional | UE · Used equipment | $117.49 | $117.49 | $213.80 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None (both parts) | $218.78 | $218.78 | $218.78 |
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 $263.03 Median $436.52 Typical High $954.99 | Facility | None | $263.03 | $436.52 | $954.99 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $173.78 Median $281.84 Typical High $467.74 | Professional | None (both parts) | $173.78 | $281.84 | $467.74 |
Excellus BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $95.50 Median $158.49 Typical High $218.78 | Professional | None (both parts) | $95.50 | $158.49 | $218.78 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None (both parts) | $213.80 | $213.80 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $389.05 | Professional | None (both parts) | $154.88 | $154.88 | $389.05 |
United Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $426.58 | Facility | None | $147.91 | $151.36 | $426.58 |
United Setting Professional Modifier None (both parts) Typical Low $87.10 Median $138.04 Typical High $199.53 | Professional | None (both parts) | $87.10 | $138.04 | $199.53 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $158.49 | Facility | None | $95.50 | $95.50 | $158.49 |
Univera Setting Professional Modifier None (both parts) Typical Low $95.50 Median $158.49 Typical High $218.78 | Professional | None (both parts) | $95.50 | $158.49 | $218.78 |
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 $56.23 Median $56.23 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 53 · Discontinued | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $16.60 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $17.78 Typical High $22.91 | Professional | 26 · Professional part | $12.02 | $17.78 | $22.91 |
Where New York sits
The same service costs 2.3 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
$162
HI $324NJ $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.