How much rates vary
Facilitymedian $68 · 10th to 90th $62 to $178Professionalmedian $63 · 10th to 90th $46 to $158
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 $36.31 Median $45.71 Typical High $66.07 | Facility | None | $36.31 | $45.71 | $66.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | None (both parts) | $45.71 | $45.71 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $213.80 | Facility | None | $107.15 | $109.65 | $213.80 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $60.26 Median $60.26 Typical High $186.21 | Professional | None (both parts) | $60.26 | $60.26 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $12.88 | Professional | RR · Rental | $6.03 | $6.03 | $12.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $89.13 | Professional | UE · Used equipment | $44.67 | $44.67 | $89.13 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Facility | None | $61.66 | $61.66 | $66.07 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $44.67 | $44.67 | $44.67 |
Emblem Health Setting Facility Modifier None Typical Low $107.15 Median $177.83 Typical High $389.05 | Facility | None | $107.15 | $177.83 | $389.05 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $70.79 Median $114.82 Typical High $190.55 | Professional | None (both parts) | $70.79 | $114.82 | $190.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $60.26 Median $67.61 Typical High $89.13 | Professional | None (both parts) | $60.26 | $67.61 | $89.13 |
MVP Health Care Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $158.49 | Professional | None (both parts) | $63.10 | $63.10 | $158.49 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $162.18 | Facility | None | $29.51 | $48.98 | $162.18 |
United Setting Professional Modifier None (both parts) Typical Low $35.48 Median $56.23 Typical High $77.62 | Professional | None (both parts) | $35.48 | $56.23 | $77.62 |
Univera Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $67.61 | Facility | None | $63.10 | $67.61 | $67.61 |
Univera Setting Professional Modifier None (both parts) Typical Low $60.26 Median $67.61 Typical High $89.13 | Professional | None (both parts) | $60.26 | $67.61 | $89.13 |
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 $22.91 Median $22.91 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $13.49 | Professional | 53 · Discontinued | $9.12 | $9.12 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.61 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.90 Median $7.08 Typical High $9.33 | Professional | 26 · Professional part | $4.90 | $7.08 | $9.33 |
Where New York sits
The same service costs 2.4 times more in Montana 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· 25th of 51
$63.10
MT $107DE $44.67
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.