How much rates vary
Facilitymedian $219 · 10th to 90th $148 to $631Professionalmedian $214 · 10th to 90th $148 to $525
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 $128.82 Median $162.18 Typical High $234.42 | Facility | None | $128.82 | $162.18 | $234.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $234.42 | Professional | None (both parts) | $162.18 | $162.18 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $758.58 | Facility | None | $380.19 | $389.05 | $758.58 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $645.65 | Professional | None (both parts) | $181.97 | $181.97 | $645.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $39.81 | Professional | RR · Rental | $18.20 | $18.20 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $245.47 | Professional | UE · Used equipment | $138.04 | $138.04 | $245.47 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None (both parts) | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Facility | None | $218.78 | $218.78 | $234.42 |
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 $380.19 Median $630.96 Typical High $1,380.38 | Facility | None | $380.19 | $630.96 | $1,380.38 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $251.19 Median $380.19 Typical High $676.08 | Professional | None (both parts) | $251.19 | $380.19 | $676.08 |
Excellus BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $147.91 Median $223.87 Typical High $309.03 | Professional | None (both parts) | $147.91 | $223.87 | $309.03 |
Fidelis 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 |
MVP Health Care Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $223.87 Median $223.87 Typical High $562.34 | Professional | None (both parts) | $223.87 | $223.87 | $562.34 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $489.78 | Facility | None | $199.53 | $204.17 | $489.78 |
United Setting Professional Modifier None (both parts) Typical Low $125.89 Median $199.53 Typical High $269.15 | Professional | None (both parts) | $125.89 | $199.53 | $269.15 |
Univera Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $223.87 | Facility | None | $147.91 | $147.91 | $223.87 |
Univera Setting Professional Modifier None (both parts) Typical Low $147.91 Median $223.87 Typical High $309.03 | Professional | None (both parts) | $147.91 | $223.87 | $309.03 |
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 $81.28 Median $81.28 Typical High $117.49 | Professional | 52 · Reduced service | $81.28 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | 53 · Discontinued | $32.36 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $35.48 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $23.44 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $25.12 Typical High $33.11 | Professional | 26 · Professional part | $17.38 | $25.12 | $33.11 |
Where New York sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$214
HI $525WV $158
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.