How much rates vary
Facilitymedian $832 · 10th to 90th $776 to $2,399Professionalmedian $813 · 10th to 90th $617 to $1,950
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 $489.78 Median $616.60 Typical High $891.25 | Facility | None | $489.78 | $616.60 | $891.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $891.25 | Professional | None (both parts) | $616.60 | $616.60 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,884.03 | Facility | None | $1,445.44 | $1,479.11 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $794.33 Median $812.83 Typical High $2,454.71 | Professional | None (both parts) | $794.33 | $812.83 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $169.82 | Professional | RR · Rental | $79.43 | $79.43 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $588.84 Typical High $1,071.52 | Professional | UE · Used equipment | $588.84 | $588.84 | $1,071.52 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None (both parts) | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $912.01 | Facility | None | $831.76 | $831.76 | $912.01 |
Cigna Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None (both parts) | $602.56 | $602.56 | $602.56 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $5,248.07 | Facility | None | $1,445.44 | $2,398.83 | $5,248.07 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $954.99 Median $1,548.82 Typical High $2,570.40 | Professional | None (both parts) | $954.99 | $1,548.82 | $2,570.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $776.25 Median $851.14 Typical High $1,202.26 | Professional | None (both parts) | $776.25 | $851.14 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $851.14 Median $851.14 Typical High $2,137.96 | Professional | None (both parts) | $851.14 | $851.14 | $2,137.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,137.96 | Facility | None | $870.96 | $1,348.96 | $2,137.96 |
United Setting Professional Modifier None (both parts) Typical Low $478.63 Median $758.58 Typical High $1,047.13 | Professional | None (both parts) | $478.63 | $758.58 | $1,047.13 |
Univera Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Facility | None | $776.25 | $776.25 | $891.25 |
Univera Setting Professional Modifier None (both parts) Typical Low $776.25 Median $851.14 Typical High $1,202.26 | Professional | None (both parts) | $776.25 | $851.14 | $1,202.26 |
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 $309.03 Median $309.03 Typical High $446.68 | Professional | 52 · Reduced service | $309.03 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | 53 · Discontinued | $123.03 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $89.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $95.50 Typical High $125.89 | Professional | 26 · Professional part | $66.07 | $95.50 | $125.89 |
Where New York sits
The same service costs 5.4 times more in Hawaii 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· 31st of 51
$813
HI $3,236DE $603
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.