How much rates vary
Facilitymedian $245 · 10th to 90th $229 to $708Professionalmedian $245 · 10th to 90th $182 to $575
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 $144.54 Median $181.97 Typical High $263.03 | Facility | None | $144.54 | $181.97 | $263.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | None (both parts) | $181.97 | $181.97 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $851.14 | Facility | None | $426.58 | $436.52 | $851.14 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $239.88 Median $245.47 Typical High $724.44 | Professional | None (both parts) | $239.88 | $245.47 | $724.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $51.29 | Professional | RR · Rental | $23.99 | $23.99 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $323.59 | Professional | UE · Used equipment | $181.97 | $181.97 | $323.59 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $275.42 | Facility | None | $245.47 | $245.47 | $275.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None (both parts) | $177.83 | $177.83 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $1,548.82 | Facility | None | $426.58 | $707.95 | $1,548.82 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $281.84 Median $457.09 Typical High $758.58 | Professional | None (both parts) | $281.84 | $457.09 | $758.58 |
Excellus BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $229.09 Median $251.19 Typical High $354.81 | Professional | None (both parts) | $229.09 | $251.19 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $630.96 | Professional | None (both parts) | $251.19 | $251.19 | $630.96 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $645.65 | Facility | None | $147.91 | $204.17 | $645.65 |
United Setting Professional Modifier None (both parts) Typical Low $141.25 Median $223.87 Typical High $309.03 | Professional | None (both parts) | $141.25 | $223.87 | $309.03 |
Univera Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Facility | None | $229.09 | $229.09 | $263.03 |
Univera Setting Professional Modifier None (both parts) Typical Low $229.09 Median $251.19 Typical High $354.81 | Professional | None (both parts) | $229.09 | $251.19 | $354.81 |
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 $91.20 Median $91.20 Typical High $131.83 | Professional | 52 · Reduced service | $91.20 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $53.70 | Professional | 53 · Discontinued | $36.31 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $39.81 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $26.30 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $28.18 Typical High $37.15 | Professional | 26 · Professional part | $19.50 | $28.18 | $37.15 |
Where New York sits
The same service costs 2.9 times more in Montana 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· 28th of 51
$245
MT $513DE $178
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.