How much rates vary
Facilitymedian $759 · 10th to 90th $550 to $1,778Professionalmedian $603 · 10th to 90th $407 to $1,514
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 $363.08 Median $676.08 Typical High $1,230.27 | Facility | None | $363.08 | $676.08 | $1,230.27 |
Aetna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $676.08 | Professional | None (both parts) | $467.74 | $467.74 | $676.08 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None (both parts) | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,096.48 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $549.54 Median $549.54 Typical High $1,819.70 | Professional | None (both parts) | $549.54 | $549.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $114.82 | Professional | RR · Rental | $53.70 | $53.70 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $407.38 Median $407.38 Typical High $724.44 | Professional | UE · Used equipment | $407.38 | $407.38 | $724.44 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None (both parts) | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
Cigna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None (both parts) | $398.11 | $398.11 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $3,890.45 | Facility | None | $1,096.48 | $1,778.28 | $3,890.45 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $707.95 Median $1,096.48 Typical High $1,905.46 | Professional | None (both parts) | $707.95 | $1,096.48 | $1,905.46 |
Excellus BCBS Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $645.65 Median $758.58 Typical High $891.25 | Professional | None (both parts) | $645.65 | $758.58 | $891.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Highmark BCBS 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 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $489.78 Median $489.78 Typical High $1,584.89 | Professional | None (both parts) | $489.78 | $489.78 | $1,584.89 |
United Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $1,318.26 | Facility | None | $331.13 | $436.52 | $1,318.26 |
United Setting Professional Modifier None (both parts) Typical Low $354.81 Median $562.34 Typical High $758.58 | Professional | None (both parts) | $354.81 | $562.34 | $758.58 |
Univera Setting Facility Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Facility | None | $645.65 | $758.58 | $758.58 |
Univera Setting Professional Modifier None (both parts) Typical Low $645.65 Median $758.58 Typical High $891.25 | Professional | None (both parts) | $645.65 | $758.58 | $891.25 |
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 $229.09 Median $229.09 Typical High $338.84 | Professional | 52 · Reduced service | $229.09 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $93.33 | $134.90 |
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 $46.77 Median $46.77 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $67.61 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $48.98 Median $72.44 Typical High $93.33 | Professional | 26 · Professional part | $48.98 | $72.44 | $93.33 |
Where New York sits
The same service costs 2.4 times more in Iowa 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· 19th of 51
$631
IA $955DE $398
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.