How much rates vary
Facilitymedian $78 · 10th to 90th $59 to $162Professionalmedian $59 · 10th to 90th $46 to $138
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 $32.36 Median $40.74 Typical High $58.88 | Facility | None | $32.36 | $40.74 | $58.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | None (both parts) | $40.74 | $40.74 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $190.55 | Facility | None | $95.50 | $97.72 | $190.55 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $169.82 | Professional | None (both parts) | $57.54 | $57.54 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $12.30 | Professional | RR · Rental | $5.75 | $5.75 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $77.62 | Professional | UE · Used equipment | $42.66 | $42.66 | $77.62 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $91.20 | Facility | None | $81.28 | $81.28 | $91.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $58.88 | $58.88 | $58.88 |
Emblem Health Setting Facility Modifier None Typical Low $95.50 Median $158.49 Typical High $346.74 | Facility | None | $95.50 | $158.49 | $346.74 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $63.10 Median $102.33 Typical High $169.82 | Professional | None (both parts) | $63.10 | $102.33 | $169.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | None (both parts) | $56.23 | $66.07 | $77.62 |
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 $56.23 Median $56.23 Typical High $141.25 | Professional | None (both parts) | $56.23 | $56.23 | $141.25 |
United Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $154.88 | Facility | None | $63.10 | $93.33 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $31.62 Median $50.12 Typical High $72.44 | Professional | None (both parts) | $31.62 | $50.12 | $72.44 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $66.07 | Facility | None | $56.23 | $66.07 | $66.07 |
Univera Setting Professional Modifier None (both parts) Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | None (both parts) | $56.23 | $66.07 | $77.62 |
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 $20.42 Median $20.42 Typical High $29.51 | Professional | 52 · Reduced service | $20.42 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 53 · Discontinued | $8.13 | $8.13 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $8.91 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.89 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.37 Median $6.31 Typical High $8.32 | Professional | 26 · Professional part | $4.37 | $6.31 | $8.32 |
Where New York sits
The same service costs 4.4 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· 42nd of 51
$58.88
HI $219FL $50.12
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.