How much rates vary
Facilitymedian $407 · 10th to 90th $316 to $1,175Professionalmedian $398 · 10th to 90th $302 to $955
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 $234.42 Median $302.00 Typical High $436.52 | Facility | None | $234.42 | $302.00 | $436.52 |
Aetna Setting Professional Modifier None (both parts) Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | None (both parts) | $302.00 | $302.00 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,412.54 | Facility | None | $707.95 | $724.44 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $380.19 Median $398.11 Typical High $1,202.26 | Professional | None (both parts) | $380.19 | $398.11 | $1,202.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $83.18 | Professional | RR · Rental | $38.02 | $38.02 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $512.86 | Professional | UE · Used equipment | $288.40 | $288.40 | $512.86 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None (both parts) | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $436.52 | Facility | None | $407.38 | $407.38 | $436.52 |
Cigna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $295.12 | $295.12 | $295.12 |
Emblem Health Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $2,570.40 | Facility | None | $707.95 | $1,174.90 | $2,570.40 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $457.09 Median $741.31 Typical High $1,258.93 | Professional | None (both parts) | $457.09 | $741.31 | $1,258.93 |
Excellus BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $316.23 Median $416.87 Typical High $575.44 | Professional | None (both parts) | $316.23 | $416.87 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $416.87 Median $416.87 Typical High $1,023.29 | Professional | None (both parts) | $416.87 | $416.87 | $1,023.29 |
United Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $1,071.52 | Facility | None | $436.52 | $575.44 | $1,071.52 |
United Setting Professional Modifier None (both parts) Typical Low $229.09 Median $363.08 Typical High $512.86 | Professional | None (both parts) | $229.09 | $363.08 | $512.86 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Facility | None | $316.23 | $316.23 | $416.87 |
Univera Setting Professional Modifier None (both parts) Typical Low $316.23 Median $416.87 Typical High $575.44 | Professional | None (both parts) | $316.23 | $416.87 | $575.44 |
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 $151.36 Median $151.36 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 53 · Discontinued | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $43.65 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $46.77 Typical High $60.26 | Professional | 26 · Professional part | $31.62 | $46.77 | $60.26 |
Where New York sits
The same service costs 4.3 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
$398
HI $1,259DE $295
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.