How much rates vary
Facilitymedian $724 · 10th to 90th $603 to $1,950Professionalmedian $661 · 10th to 90th $513 to $1,698
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 $398.11 Median $512.86 Typical High $741.31 | Facility | None | $398.11 | $512.86 | $741.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $512.86 Typical High $741.31 | Professional | None (both parts) | $512.86 | $512.86 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,398.83 | Facility | None | $1,202.26 | $1,202.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $660.69 Median $660.69 Typical High $2,089.30 | Professional | None (both parts) | $660.69 | $660.69 | $2,089.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $141.25 | Professional | RR · Rental | $66.07 | $66.07 | $141.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $489.78 Typical High $891.25 | Professional | UE · Used equipment | $489.78 | $489.78 | $891.25 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Facility | None | $741.31 | $741.31 | $776.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None (both parts) | $537.03 | $537.03 | $537.03 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,949.84 | $4,265.80 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $776.25 Median $1,202.26 Typical High $2,089.30 | Professional | None (both parts) | $776.25 | $1,202.26 | $2,089.30 |
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 $602.56 Median $707.95 Typical High $977.24 | Professional | None (both parts) | $602.56 | $707.95 | $977.24 |
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 $691.83 Median $691.83 Typical High $1,737.80 | Professional | None (both parts) | $691.83 | $691.83 | $1,737.80 |
United Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $1,698.24 | Facility | None | $645.65 | $691.83 | $1,698.24 |
United Setting Professional Modifier None (both parts) Typical Low $389.05 Median $616.60 Typical High $851.14 | Professional | None (both parts) | $389.05 | $616.60 | $851.14 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Facility | None | $602.56 | $602.56 | $724.44 |
Univera Setting Professional Modifier None (both parts) Typical Low $602.56 Median $707.95 Typical High $977.24 | Professional | None (both parts) | $602.56 | $707.95 | $977.24 |
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 $251.19 Median $251.19 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $251.19 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $74.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $79.43 Typical High $102.33 | Professional | 26 · Professional part | $53.70 | $79.43 | $102.33 |
Where New York sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$661
HI $1,622VT $537
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.