How much rates vary
Facilitymedian $603 · 10th to 90th $562 to $1,660Professionalmedian $562 · 10th to 90th $427 to $1,349
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 $338.84 Median $426.58 Typical High $630.96 | Facility | None | $338.84 | $426.58 | $630.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $426.58 Median $426.58 Typical High $630.96 | Professional | None (both parts) | $426.58 | $426.58 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $2,041.74 | Facility | None | $1,000.00 | $1,023.29 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $524.81 Median $537.03 Typical High $1,698.24 | Professional | None (both parts) | $524.81 | $537.03 | $1,698.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $112.20 | Professional | RR · Rental | $52.48 | $52.48 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $398.11 Typical High $707.95 | Professional | UE · Used equipment | $398.11 | $398.11 | $707.95 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None (both parts) | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $602.56 | Facility | None | $562.34 | $562.34 | $602.56 |
Cigna Setting Professional Modifier None (both parts) Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None (both parts) | $416.87 | $416.87 | $416.87 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,630.78 | Facility | None | $1,000.00 | $1,659.59 | $3,630.78 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $660.69 Median $1,071.52 Typical High $1,778.28 | Professional | None (both parts) | $660.69 | $1,071.52 | $1,778.28 |
Excellus BCBS Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $588.84 Median $602.56 Typical High $831.76 | Professional | None (both parts) | $588.84 | $602.56 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $588.84 Median $588.84 Typical High $1,479.11 | Professional | None (both parts) | $588.84 | $588.84 | $1,479.11 |
United Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,412.54 | Facility | None | $549.54 | $660.69 | $1,412.54 |
United Setting Professional Modifier None (both parts) Typical Low $331.13 Median $524.81 Typical High $707.95 | Professional | None (both parts) | $331.13 | $524.81 | $707.95 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $616.60 | Facility | None | $588.84 | $602.56 | $616.60 |
Univera Setting Professional Modifier None (both parts) Typical Low $588.84 Median $602.56 Typical High $831.76 | Professional | None (both parts) | $588.84 | $602.56 | $831.76 |
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 $213.80 Median $213.80 Typical High $309.03 | Professional | 52 · Reduced service | $213.80 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $125.89 | Professional | 53 · Discontinued | $87.10 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $93.33 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $63.10 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $67.61 Typical High $87.10 | Professional | 26 · Professional part | $45.71 | $67.61 | $87.10 |
Where New York sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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· 27th of 51
$562
HI $1,230KS $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.