How much rates vary
Facilitymedian $191 · 10th to 90th $182 to $525Professionalmedian $186 · 10th to 90th $138 to $447
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 $102.33 Median $131.83 Typical High $190.55 | Facility | None | $102.33 | $131.83 | $190.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | None (both parts) | $131.83 | $131.83 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $616.60 | Facility | None | $309.03 | $316.23 | $616.60 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $549.54 | Professional | None (both parts) | $186.21 | $186.21 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $39.81 | Professional | RR · Rental | $18.62 | $18.62 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $251.19 | Professional | UE · Used equipment | $138.04 | $138.04 | $251.19 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None (both parts) | $138.04 | $138.04 | $138.04 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $1,122.02 | Facility | None | $309.03 | $512.86 | $1,122.02 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $199.53 Median $331.13 Typical High $549.54 | Professional | None (both parts) | $199.53 | $331.13 | $549.54 |
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 $181.97 Median $186.21 Typical High $251.19 | Professional | None (both parts) | $181.97 | $186.21 | $251.19 |
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 $141.25 Median $141.25 Typical High $457.09 | Professional | None (both parts) | $141.25 | $141.25 | $457.09 |
United Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $501.19 | Facility | None | $125.89 | $173.78 | $501.19 |
United Setting Professional Modifier None (both parts) Typical Low $100.00 Median $162.18 Typical High $234.42 | Professional | None (both parts) | $100.00 | $162.18 | $234.42 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $190.55 | Facility | None | $181.97 | $186.21 | $190.55 |
Univera Setting Professional Modifier None (both parts) Typical Low $181.97 Median $186.21 Typical High $251.19 | Professional | None (both parts) | $181.97 | $186.21 | $251.19 |
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 $66.07 Median $66.07 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $38.02 | Professional | 53 · Discontinued | $26.30 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $19.05 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $14.13 Median $20.42 Typical High $26.92 | Professional | 26 · Professional part | $14.13 | $20.42 | $26.92 |
Where New York sits
The same service costs 2.7 times more in Hawaii 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· 33rd of 51
$186
HI $372DE $138
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.