How much rates vary
Facilitymedian $112 · 10th to 90th $95 to $282Professionalmedian $98 · 10th to 90th $72 to $251
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 $288.40 | Professional | None (both parts) | $72.44 | $72.44 | $288.40 |
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 $91.20 Median $91.20 Typical High $288.40 | Professional | None (both parts) | $91.20 | $91.20 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $19.05 | Professional | RR · Rental | $8.91 | $8.91 | $19.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $120.23 | Professional | UE · Used equipment | $66.07 | $66.07 | $120.23 |
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 $95.50 Median $97.72 Typical High $97.72 | Facility | None | $95.50 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | None (both parts) | $70.79 | $70.79 | $95.50 |
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 $173.78 Typical High $302.00 | Professional | None (both parts) | $109.65 | $173.78 | $302.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $100.00 Median $112.20 Typical High $138.04 | Professional | None (both parts) | $100.00 | $112.20 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $245.47 | Professional | None (both parts) | $75.86 | $75.86 | $245.47 |
United Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $239.88 | Facility | None | $79.43 | $89.13 | $239.88 |
United Setting Professional Modifier None (both parts) Typical Low $54.95 Median $87.10 Typical High $120.23 | Professional | None (both parts) | $54.95 | $87.10 | $120.23 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $112.20 Typical High $112.20 | Facility | None | $100.00 | $112.20 | $112.20 |
Univera Setting Professional Modifier None (both parts) Typical Low $100.00 Median $112.20 Typical High $138.04 | Professional | None (both parts) | $100.00 | $112.20 | $138.04 |
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 $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 $10.72 Median $10.72 Typical High $15.85 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $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 $7.59 Median $11.22 Typical High $14.45 | Professional | 26 · Professional part | $7.59 | $11.22 | $14.45 |
Fidelis Setting Professional Modifier KX · Policy requirements met Typical Low $74.13 Median $74.13 Typical High $104.71 | Professional | KX · Policy requirements met | $74.13 | $74.13 | $104.71 |
Where New York sits
The same service costs 2.8 times more in Hawaii 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· 24th of 51
$100
HI $195FL $70.79
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.