How much rates vary
Facilitymedian $741 · 10th to 90th $631 to $1,820Professionalmedian $646 · 10th to 90th $479 to $1,549
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 $354.81 Median $457.09 Typical High $660.69 | Facility | None | $354.81 | $457.09 | $660.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $457.09 Median $457.09 Typical High $660.69 | Professional | None (both parts) | $457.09 | $457.09 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $2,137.96 | Facility | None | $1,071.52 | $1,096.48 | $2,137.96 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $1,862.09 | Professional | None (both parts) | $602.56 | $602.56 | $1,862.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $125.89 | Professional | RR · Rental | $57.54 | $57.54 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $436.52 Typical High $776.25 | Professional | UE · Used equipment | $436.52 | $436.52 | $776.25 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None (both parts) | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $891.25 | Facility | None | $724.44 | $724.44 | $891.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None (both parts) | $537.03 | $537.03 | $537.03 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,890.45 | Facility | None | $1,071.52 | $1,778.28 | $3,890.45 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $691.83 Median $1,071.52 Typical High $1,905.46 | Professional | None (both parts) | $691.83 | $1,071.52 | $1,905.46 |
Excellus BCBS Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $630.96 Median $741.31 Typical High $870.96 | Professional | None (both parts) | $630.96 | $741.31 | $870.96 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None (both parts) | $851.14 | $851.14 | $851.14 |
MVP Health Care Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $645.65 Median $645.65 Typical High $1,548.82 | Professional | None (both parts) | $645.65 | $645.65 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Facility | None | $1,318.26 | $1,318.26 | $1,698.24 |
United Setting Professional Modifier None (both parts) Typical Low $346.74 Median $549.54 Typical High $758.58 | Professional | None (both parts) | $346.74 | $549.54 | $758.58 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $741.31 | Facility | None | $602.56 | $741.31 | $741.31 |
Univera Setting Professional Modifier None (both parts) Typical Low $630.96 Median $741.31 Typical High $870.96 | Professional | None (both parts) | $630.96 | $741.31 | $870.96 |
3 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 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $100.00 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $66.07 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $11.75 Typical High $12.02 | Professional | 26 · Professional part | $10.72 | $11.75 | $12.02 |
Where New York sits
The same service costs 2.0 times more in Montana 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· 27th of 51
$646
MT $1,096WV $537
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.