How much rates vary
Facilitymedian $851 · 10th to 90th $851 to $3,020Professionalmedian $1,023 · 10th to 90th $676 to $2,512
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 $616.60 Median $776.25 Typical High $1,122.02 | Facility | None | $616.60 | $776.25 | $1,122.02 |
Aetna Setting Professional Modifier None (both parts) Typical Low $776.25 Median $776.25 Typical High $1,122.02 | Professional | None (both parts) | $776.25 | $776.25 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $3,630.78 | Facility | None | $1,819.70 | $1,862.09 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $794.33 Median $794.33 Typical High $3,090.30 | Professional | None (both parts) | $794.33 | $794.33 | $3,090.30 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None (both parts) | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $912.01 | Facility | None | $851.14 | $851.14 | $912.01 |
Cigna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $616.60 | $616.60 | $616.60 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,019.95 Typical High $6,606.93 | Facility | None | $1,819.70 | $3,019.95 | $6,606.93 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,202.26 Median $1,819.70 Typical High $3,235.94 | Professional | None (both parts) | $1,202.26 | $1,819.70 | $3,235.94 |
Excellus BCBS Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $851.14 Median $1,071.52 Typical High $1,513.56 | Professional | None (both parts) | $851.14 | $1,071.52 | $1,513.56 |
MVP Health Care Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,071.52 Typical High $2,691.53 | Professional | None (both parts) | $1,071.52 | $1,071.52 | $2,691.53 |
United Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $2,187.76 | Facility | None | $630.96 | $776.25 | $2,187.76 |
United Setting Professional Modifier None (both parts) Typical Low $602.56 Median $954.99 Typical High $1,258.93 | Professional | None (both parts) | $602.56 | $954.99 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Facility | None | $851.14 | $851.14 | $1,071.52 |
Univera Setting Professional Modifier None (both parts) Typical Low $851.14 Median $1,071.52 Typical High $1,513.56 | Professional | None (both parts) | $851.14 | $1,071.52 | $1,513.56 |
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 $389.05 Median $389.05 Typical High $562.34 | Professional | 52 · Reduced service | $389.05 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $112.20 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $112.20 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | 26 · Professional part | $83.18 | $120.23 | $158.49 |
Where New York sits
The same service costs 3.0 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· 18th of 51
$1,023
HI $1,820DE $617
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.