How much rates vary
Facilitymedian $214 · 10th to 90th $186 to $407Professionalmedian $204 · 10th to 90th $155 to $457
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 $120.23 Median $154.88 Typical High $173.78 | Facility | None | $120.23 | $154.88 | $173.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | None (both parts) | $154.88 | $154.88 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $457.09 | Facility | None | $229.09 | $234.42 | $457.09 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $616.60 | Professional | None (both parts) | $204.17 | $204.17 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $42.66 | Professional | RR · Rental | $19.95 | $19.95 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $263.03 | Professional | UE · Used equipment | $147.91 | $147.91 | $263.03 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | None | $213.80 | $213.80 | $239.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None (both parts) | $158.49 | $158.49 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $229.09 Median $380.19 Typical High $831.76 | Facility | None | $229.09 | $380.19 | $831.76 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $147.91 Median $239.88 Typical High $407.38 | Professional | None (both parts) | $147.91 | $239.88 | $407.38 |
Excellus BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $186.21 Median $204.17 Typical High $234.42 | Professional | None (both parts) | $186.21 | $204.17 | $234.42 |
Fidelis Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $125.89 | $125.89 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $380.19 | Professional | None (both parts) | $213.80 | $213.80 | $380.19 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $489.78 | Facility | None | $213.80 | $234.42 | $489.78 |
United Setting Professional Modifier None (both parts) Typical Low $117.49 Median $186.21 Typical High $251.19 | Professional | None (both parts) | $117.49 | $186.21 | $251.19 |
Univera Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $223.87 | Facility | None | $186.21 | $186.21 | $223.87 |
Univera Setting Professional Modifier None (both parts) Typical Low $186.21 Median $204.17 Typical High $234.42 | Professional | None (both parts) | $186.21 | $204.17 | $234.42 |
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 $77.62 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $30.90 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $17.38 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $15.85 Median $23.99 Typical High $30.90 | Professional | 26 · Professional part | $15.85 | $23.99 | $30.90 |
Where New York sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 22nd of 51
$204
HI $437UT $151
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.