How much rates vary
Facilitymedian $617 · 10th to 90th $457 to $1,549Professionalmedian $525 · 10th to 90th $339 to $1,318
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 $309.03 Median $398.11 Typical High $575.44 | Facility | None | $309.03 | $398.11 | $575.44 |
Aetna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $1,584.89 | Professional | None (both parts) | $398.11 | $398.11 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $1,862.09 | Facility | None | $933.25 | $954.99 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $338.84 Median $338.84 Typical High $1,584.89 | Professional | None (both parts) | $338.84 | $338.84 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | RR · Rental | $33.11 | $33.11 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $398.11 | Professional | UE · Used equipment | $199.53 | $199.53 | $398.11 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None (both parts) | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $524.81 | Facility | None | $457.09 | $457.09 | $524.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | None (both parts) | $338.84 | $338.84 | $457.09 |
Emblem Health Setting Facility Modifier None Typical Low $933.25 Median $1,548.82 Typical High $3,388.44 | Facility | None | $933.25 | $1,548.82 | $3,388.44 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $602.56 Median $933.25 Typical High $1,659.59 | Professional | None (both parts) | $602.56 | $933.25 | $1,659.59 |
Excellus BCBS Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $549.54 Median $616.60 Typical High $758.58 | Professional | None (both parts) | $549.54 | $616.60 | $758.58 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None (both parts) | $741.31 | $741.31 | $741.31 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $1,348.96 | Professional | None (both parts) | $407.38 | $407.38 | $1,348.96 |
United Setting Facility Modifier None Typical Low $407.38 Median $933.25 Typical High $1,202.26 | Facility | None | $407.38 | $933.25 | $1,202.26 |
United Setting Professional Modifier None (both parts) Typical Low $302.00 Median $478.63 Typical High $645.65 | Professional | None (both parts) | $302.00 | $478.63 | $645.65 |
Univera Setting Facility Modifier None Typical Low $549.54 Median $616.60 Typical High $616.60 | Facility | None | $549.54 | $616.60 | $616.60 |
Univera Setting Professional Modifier None (both parts) Typical Low $549.54 Median $616.60 Typical High $758.58 | Professional | None (both parts) | $549.54 | $616.60 | $758.58 |
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 $199.53 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $199.53 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | 53 · Discontinued | $79.43 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $57.54 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $61.66 Typical High $79.43 | Professional | 26 · Professional part | $41.69 | $61.66 | $79.43 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 23rd of 51
$525
HI $871NH $339
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.