How much rates vary
Facilitymedian $437 · 10th to 90th $398 to $1,230Professionalmedian $417 · 10th to 90th $316 to $955
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 $239.88 Median $295.12 Typical High $426.58 | Facility | None | $239.88 | $295.12 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $1,380.38 | Facility | None | $691.83 | $707.95 | $1,380.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,174.90 | Professional | None | $389.05 | $389.05 | $1,174.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $85.11 | Professional | RR · Rental | $38.90 | $38.90 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $524.81 | Professional | UE · Used equipment | $295.12 | $295.12 | $524.81 |
CDPHP Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $467.74 | Facility | None | $436.52 | $436.52 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $2,511.89 | Facility | None | $691.83 | $1,148.15 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,230.27 | Professional | None | $446.68 | $691.83 | $1,230.27 |
Excellus BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $562.34 | Professional | None | $398.11 | $426.58 | $562.34 |
Fidelis Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
MVP Health Care Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,000.00 | Professional | None | $416.87 | $416.87 | $1,000.00 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Facility | None | $851.14 | $851.14 | $1,096.48 |
United Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $512.86 | Professional | None | $223.87 | $354.81 | $512.86 |
Univera Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Facility | None | $398.11 | $398.11 | $426.58 |
Univera Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $562.34 | Professional | None | $398.11 | $426.58 | $562.34 |
4 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 $147.91 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $42.66 |
Where New York sits
The same service costs 2.3 times more in Montana than in Delaware. 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· 29th of 51
$417
MT $741DE $316
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.