How much rates vary
Facilitymedian $87 · 10th to 90th $76 to $229Professionalmedian $85 · 10th to 90th $63 to $200
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 $46.77 Median $58.88 Typical High $87.10 | Facility | None | $46.77 | $58.88 | $87.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $87.10 | Professional | None (both parts) | $58.88 | $58.88 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $281.84 | Facility | None | $138.04 | $141.25 | $281.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $245.47 | Professional | None (both parts) | $85.11 | $85.11 | $245.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $17.78 | Professional | RR · Rental | $8.13 | $8.13 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $138.04 | Professional | UE · Used equipment | $61.66 | $61.66 | $138.04 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None (both parts) | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $95.50 | Facility | None | $81.28 | $87.10 | $95.50 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | None (both parts) | $63.10 | $63.10 | $81.28 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $501.19 | Facility | None | $138.04 | $229.09 | $501.19 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $91.20 Median $147.91 Typical High $245.47 | Professional | None (both parts) | $91.20 | $147.91 | $245.47 |
Excellus BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $75.86 Median $79.43 Typical High $114.82 | Professional | None (both parts) | $75.86 | $79.43 | $114.82 |
Fidelis Setting Professional Modifier None (both parts) Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $51.29 | $52.48 | $52.48 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $112.20 | $112.20 | $112.20 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $204.17 | Professional | None (both parts) | $63.10 | $63.10 | $204.17 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $218.78 | Facility | None | $91.20 | $120.23 | $218.78 |
United Setting Professional Modifier None (both parts) Typical Low $45.71 Median $72.44 Typical High $102.33 | Professional | None (both parts) | $45.71 | $72.44 | $102.33 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
Univera Setting Professional Modifier None (both parts) Typical Low $75.86 Median $79.43 Typical High $114.82 | Professional | None (both parts) | $75.86 | $79.43 | $114.82 |
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 $29.51 Median $29.51 Typical High $42.66 | Professional | 52 · Reduced service | $29.51 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | 53 · Discontinued | $12.02 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $12.88 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $8.71 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $6.31 Median $9.33 Typical High $12.02 | Professional | 26 · Professional part | $6.31 | $9.33 | $12.02 |
Where New York sits
The same service costs 5.0 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· 32nd of 51
$85.11
HI $316DE $63.10
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.