How much rates vary
Facilitymedian $59 · 10th to 90th $49 to $138Professionalmedian $49 · 10th to 90th $36 to $120
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 $28.18 Median $52.48 Typical High $97.72 | Facility | None | $28.18 | $52.48 | $97.72 |
Aetna Setting Professional Modifier None (both parts) Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | None (both parts) | $36.31 | $36.31 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $169.82 | Facility | None | $85.11 | $87.10 | $169.82 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $147.91 | Professional | None (both parts) | $46.77 | $46.77 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $9.77 | Professional | RR · Rental | $4.57 | $4.57 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $61.66 | Professional | UE · Used equipment | $33.88 | $33.88 | $61.66 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $53.70 | Facility | None | $48.98 | $48.98 | $53.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None (both parts) | $35.48 | $35.48 | $35.48 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $138.04 Typical High $302.00 | Facility | None | $85.11 | $138.04 | $302.00 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $54.95 Median $85.11 Typical High $147.91 | Professional | None (both parts) | $54.95 | $85.11 | $147.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | None (both parts) | $50.12 | $58.88 | $69.18 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $67.61 | $67.61 | $67.61 |
MVP Health Care Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $123.03 | Professional | None (both parts) | $48.98 | $48.98 | $123.03 |
United Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $123.03 | Facility | None | $50.12 | $64.57 | $123.03 |
United Setting Professional Modifier None (both parts) Typical Low $27.54 Median $43.65 Typical High $61.66 | Professional | None (both parts) | $27.54 | $43.65 | $61.66 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $58.88 | Facility | None | $50.12 | $58.88 | $58.88 |
Univera Setting Professional Modifier None (both parts) Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | None (both parts) | $50.12 | $58.88 | $69.18 |
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 $18.20 Median $18.20 Typical High $26.30 | Professional | 52 · Reduced service | $18.20 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $10.47 | Professional | 53 · Discontinued | $7.24 | $7.24 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $7.76 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $5.25 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $3.80 Median $5.62 Typical High $7.24 | Professional | 26 · Professional part | $3.80 | $5.62 | $7.24 |
Where New York sits
The same service costs 4.7 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
$50.12
HI $166DE $35.48
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.