How much rates vary
Facilitymedian $331 · 10th to 90th $229 to $851Professionalmedian $302 · 10th to 90th $229 to $724
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 $169.82 Median $213.80 Typical High $309.03 | Facility | None | $169.82 | $213.80 | $309.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $309.03 | Professional | None (both parts) | $213.80 | $213.80 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $1,000.00 | Facility | None | $501.19 | $512.86 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $302.00 Median $302.00 Typical High $891.25 | Professional | None (both parts) | $302.00 | $302.00 | $891.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $64.57 | Professional | RR · Rental | $30.20 | $30.20 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $407.38 | Professional | UE · Used equipment | $223.87 | $223.87 | $407.38 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None (both parts) | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $281.84 | $281.84 | $281.84 |
Emblem Health Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $1,819.70 | Facility | None | $501.19 | $831.76 | $1,819.70 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $331.13 Median $524.81 Typical High $891.25 | Professional | None (both parts) | $331.13 | $524.81 | $891.25 |
Excellus BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $229.09 Median $295.12 Typical High $407.38 | Professional | None (both parts) | $229.09 | $295.12 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $741.31 | Professional | None (both parts) | $295.12 | $295.12 | $741.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $812.83 | Facility | None | $331.13 | $426.58 | $812.83 |
United Setting Professional Modifier None (both parts) Typical Low $165.96 Median $263.03 Typical High $380.19 | Professional | None (both parts) | $165.96 | $263.03 | $380.19 |
Univera Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $295.12 | Facility | None | $229.09 | $229.09 | $295.12 |
Univera Setting Professional Modifier None (both parts) Typical Low $229.09 Median $295.12 Typical High $407.38 | Professional | None (both parts) | $229.09 | $295.12 | $407.38 |
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 $107.15 Median $107.15 Typical High $154.88 | Professional | 52 · Reduced service | $107.15 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $61.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $30.90 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $33.11 Typical High $43.65 | Professional | 26 · Professional part | $22.91 | $33.11 | $43.65 |
Where New York sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 35th of 51
$302
HI $891DC $263
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.