How much rates vary
Facilitymedian $550 · 10th to 90th $501 to $1,413Professionalmedian $479 · 10th to 90th $363 to $1,148
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 $281.84 Median $524.81 Typical High $977.24 | Facility | None | $281.84 | $524.81 | $977.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $524.81 | Professional | None (both parts) | $363.08 | $363.08 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $1,698.24 | Facility | None | $851.14 | $870.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $389.05 Median $389.05 Typical High $1,445.44 | Professional | None (both parts) | $389.05 | $389.05 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $81.28 | Professional | RR · Rental | $38.02 | $38.02 | $81.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $501.19 | Professional | UE · Used equipment | $281.84 | $281.84 | $501.19 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None (both parts) | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Facility | None | $524.81 | $524.81 | $645.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None (both parts) | $380.19 | $380.19 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $851.14 Median $1,412.54 Typical High $3,090.30 | Facility | None | $851.14 | $1,412.54 | $3,090.30 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $549.54 Median $851.14 Typical High $1,513.56 | Professional | None (both parts) | $549.54 | $851.14 | $1,513.56 |
Excellus BCBS Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $501.19 Median $549.54 Typical High $691.83 | Professional | None (both parts) | $501.19 | $549.54 | $691.83 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None (both parts) | $676.08 | $676.08 | $676.08 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $1,230.27 | Professional | None (both parts) | $446.68 | $446.68 | $1,230.27 |
United Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $1,023.29 | Facility | None | $389.05 | $416.87 | $1,023.29 |
United Setting Professional Modifier None (both parts) Typical Low $275.42 Median $436.52 Typical High $588.84 | Professional | None (both parts) | $275.42 | $436.52 | $588.84 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Facility | None | $501.19 | $549.54 | $549.54 |
Univera Setting Professional Modifier None (both parts) Typical Low $501.19 Median $549.54 Typical High $691.83 | Professional | None (both parts) | $501.19 | $549.54 | $691.83 |
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 $181.97 Median $181.97 Typical High $263.03 | Professional | 52 · Reduced service | $181.97 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | 53 · Discontinued | $72.44 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $79.43 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $52.48 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $56.23 Typical High $72.44 | Professional | 26 · Professional part | $38.02 | $56.23 | $72.44 |
Where New York sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 18th of 51
$501
HI $977MD $355
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.