How much rates vary
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 $602.56 Median $776.25 Typical High $1,122.02 | Facility | None | $602.56 | $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 $812.83 Median $812.83 Typical High $3,090.30 | Professional | None (both parts) | $812.83 | $812.83 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $173.78 | Professional | RR · Rental | $81.28 | $81.28 | $173.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $1,096.48 | Professional | UE · Used equipment | $602.56 | $602.56 | $1,096.48 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Facility | None | $831.76 | $831.76 | $891.25 |
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 $1,819.70 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 $1,174.90 Median $1,819.70 Typical High $3,235.94 | Professional | None (both parts) | $1,174.90 | $1,819.70 | $3,235.94 |
Excellus BCBS Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,071.52 Typical High $1,479.11 | Professional | None (both parts) | $977.24 | $1,071.52 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,047.13 Typical High $2,630.27 | Professional | None (both parts) | $1,047.13 | $1,047.13 | $2,630.27 |
United Setting Facility Modifier None Typical Low $870.96 Median $891.25 Typical High $2,187.76 | Facility | None | $870.96 | $891.25 | $2,187.76 |
United Setting Professional Modifier None (both parts) Typical Low $588.84 Median $933.25 Typical High $1,258.93 | Professional | None (both parts) | $588.84 | $933.25 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Facility | None | $977.24 | $977.24 | $1,122.02 |
Univera Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,071.52 Typical High $1,479.11 | Professional | None (both parts) | $977.24 | $1,071.52 | $1,479.11 |
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 $223.87 | Professional | 53 · Discontinued | $154.88 | $154.88 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $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 $81.28 Median $120.23 Typical High $154.88 | Professional | 26 · Professional part | $81.28 | $120.23 | $154.88 |
Where New York sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 17th of 51
$1,023
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.