How much rates vary
Facilitymedian $39 · 10th to 90th $35 to $95Professionalmedian $33 · 10th to 90th $26 to $81
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 $19.05 Median $23.99 Typical High $34.67 | Facility | None | $19.05 | $23.99 | $34.67 |
Aetna Setting Professional Modifier None (both parts) Typical Low $23.99 Median $23.99 Typical High $34.67 | Professional | None (both parts) | $23.99 | $23.99 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $112.20 | Facility | None | $56.23 | $57.54 | $112.20 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $97.72 | Professional | None (both parts) | $33.11 | $33.11 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $6.92 | Professional | RR · Rental | $3.24 | $3.24 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $43.65 | Professional | UE · Used equipment | $23.99 | $23.99 | $43.65 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None (both parts) | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $43.65 | Facility | None | $38.90 | $38.90 | $43.65 |
Cigna Setting Professional Modifier None (both parts) Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None (both parts) | $28.84 | $28.84 | $28.84 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $204.17 | Facility | None | $56.23 | $93.33 | $204.17 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $37.15 Median $58.88 Typical High $100.00 | Professional | None (both parts) | $37.15 | $58.88 | $100.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $33.11 Median $38.90 Typical High $45.71 | Professional | None (both parts) | $33.11 | $38.90 | $45.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Highmark BCBS 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 |
MVP Health Care Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $83.18 | Professional | None (both parts) | $25.70 | $25.70 | $83.18 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $87.10 | Facility | None | $35.48 | $51.29 | $87.10 |
United Setting Professional Modifier None (both parts) Typical Low $18.62 Median $29.51 Typical High $41.69 | Professional | None (both parts) | $18.62 | $29.51 | $41.69 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $38.90 Typical High $38.90 | Facility | None | $33.11 | $38.90 | $38.90 |
Univera Setting Professional Modifier None (both parts) Typical Low $33.11 Median $38.90 Typical High $45.71 | Professional | None (both parts) | $33.11 | $38.90 | $45.71 |
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 $12.02 Median $12.02 Typical High $17.38 | Professional | 52 · Reduced service | $12.02 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | 53 · Discontinued | $4.79 | $4.79 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $5.25 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $3.47 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $2.51 Median $3.72 Typical High $4.90 | Professional | 26 · Professional part | $2.51 | $3.72 | $4.90 |
Where New York sits
The same service costs 4.7 times more in Hawaii than in Florida. 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· 31st of 51
$33.11
HI $132FL $28.18
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.