How much rates vary
Facilitymedian $407 · 10th to 90th $380 to $1,479Professionalmedian $447 · 10th to 90th $324 to $1,202
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 $295.12 Median $380.19 Typical High $549.54 | Facility | None | $295.12 | $380.19 | $549.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $549.54 | Professional | None (both parts) | $380.19 | $380.19 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $1,778.28 | Facility | None | $891.25 | $912.01 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $1,513.56 | Professional | None (both parts) | $398.11 | $398.11 | $1,513.56 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | None (both parts) | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $457.09 | Facility | None | $407.38 | $407.38 | $457.09 |
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 $891.25 Median $1,479.11 Typical High $3,235.94 | Facility | None | $891.25 | $1,479.11 | $3,235.94 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $575.44 Median $891.25 Typical High $1,584.89 | Professional | None (both parts) | $575.44 | $891.25 | $1,584.89 |
Excellus BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $380.19 Median $524.81 Typical High $724.44 | Professional | None (both parts) | $380.19 | $524.81 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $1,288.25 | Professional | None (both parts) | $407.38 | $407.38 | $1,288.25 |
United Setting Facility Modifier None Typical Low $436.52 Median $891.25 Typical High $1,148.15 | Facility | None | $436.52 | $891.25 | $1,148.15 |
United Setting Professional Modifier None (both parts) Typical Low $288.40 Median $457.09 Typical High $616.60 | Professional | None (both parts) | $288.40 | $457.09 | $616.60 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Facility | None | $380.19 | $380.19 | $524.81 |
Univera Setting Professional Modifier None (both parts) Typical Low $380.19 Median $524.81 Typical High $724.44 | Professional | None (both parts) | $380.19 | $524.81 | $724.44 |
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 $190.55 Median $190.55 Typical High $275.42 | Professional | 52 · Reduced service | $190.55 | $190.55 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | 53 · Discontinued | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $54.95 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $39.81 Median $58.88 Typical High $75.86 | Professional | 26 · Professional part | $39.81 | $58.88 | $75.86 |
Where New York sits
The same service costs 3.5 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· 23rd of 51
$437
HI $1,122DE $316
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.