How much rates vary
Facilitymedian $58 · 10th to 90th $46 to $200Professionalmedian $60 · 10th to 90th $46 to $174
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 $39.81 Median $51.29 Typical High $74.13 | Facility | None | $39.81 | $51.29 | $74.13 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $204.17 | Professional | None (both parts) | $51.29 | $51.29 | $204.17 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | None (both parts) | $61.66 | $61.66 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $239.88 | Facility | None | $120.23 | $123.03 | $239.88 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $204.17 | Professional | None (both parts) | $54.95 | $54.95 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $11.75 | Professional | RR · Rental | $5.50 | $5.50 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $74.13 | Professional | UE · Used equipment | $40.74 | $40.74 | $74.13 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None (both parts) | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $64.57 | Facility | None | $57.54 | $57.54 | $64.57 |
Cigna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None (both parts) | $42.66 | $42.66 | $57.54 |
Emblem Health Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $436.52 | Facility | None | $120.23 | $199.53 | $436.52 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $77.62 Median $120.23 Typical High $213.80 | Professional | None (both parts) | $77.62 | $120.23 | $213.80 |
Excellus BCBS Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $45.71 Median $67.61 Typical High $97.72 | Professional | None (both parts) | $45.71 | $67.61 | $97.72 |
Fidelis Setting Professional Modifier None (both parts) Typical Low $30.90 Median $30.90 Typical High $107.15 | Professional | None (both parts) | $30.90 | $30.90 | $107.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | None (both parts) | $95.50 | $95.50 | $102.33 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $173.78 | Professional | None (both parts) | $54.95 | $54.95 | $173.78 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $147.91 | Facility | None | $43.65 | $51.29 | $147.91 |
United Setting Professional Modifier None (both parts) Typical Low $38.90 Median $61.66 Typical High $83.18 | Professional | None (both parts) | $38.90 | $61.66 | $83.18 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $67.61 | Facility | None | $45.71 | $45.71 | $67.61 |
Univera Setting Professional Modifier None (both parts) Typical Low $45.71 Median $67.61 Typical High $97.72 | Professional | None (both parts) | $45.71 | $67.61 | $97.72 |
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 $25.70 Median $25.70 Typical High $37.15 | Professional | 52 · Reduced service | $25.70 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $14.79 | Professional | 53 · Discontinued | $10.23 | $10.23 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $11.22 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $7.41 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $5.25 Median $7.94 Typical High $10.23 | Professional | 26 · Professional part | $5.25 | $7.94 | $10.23 |
Where New York sits
The same service costs 2.6 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· 26th of 51
$60.26
HI $117DE $44.67
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.