How much rates vary
Facilitymedian $158 · 10th to 90th $76 to $447Professionalmedian $155 · 10th to 90th $107 to $380
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 $87.10 Median $112.20 Typical High $162.18 | Facility | None | $87.10 | $112.20 | $162.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | None (both parts) | $112.20 | $112.20 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $524.81 | Facility | None | $263.03 | $269.15 | $524.81 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $457.09 | Professional | None (both parts) | $154.88 | $154.88 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $33.88 | Professional | RR · Rental | $15.49 | $15.49 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $208.93 | Professional | UE · Used equipment | $117.49 | $117.49 | $208.93 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None (both parts) | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Facility | None | $158.49 | $158.49 | $186.21 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $117.49 | $117.49 | $117.49 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $933.25 | Facility | None | $263.03 | $426.58 | $933.25 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $169.82 Median $281.84 Typical High $457.09 | Professional | None (both parts) | $169.82 | $281.84 | $457.09 |
Excellus BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $75.86 Median $154.88 Typical High $213.80 | Professional | None (both parts) | $75.86 | $154.88 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $151.36 Median $151.36 Typical High $380.19 | Professional | None (both parts) | $151.36 | $151.36 | $380.19 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $416.87 | Facility | None | $141.25 | $169.82 | $416.87 |
United Setting Professional Modifier None (both parts) Typical Low $85.11 Median $134.90 Typical High $194.98 | Professional | None (both parts) | $85.11 | $134.90 | $194.98 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $154.88 | Facility | None | $75.86 | $75.86 | $154.88 |
Univera Setting Professional Modifier None (both parts) Typical Low $75.86 Median $154.88 Typical High $213.80 | Professional | None (both parts) | $75.86 | $154.88 | $213.80 |
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 $56.23 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $32.36 | Professional | 53 · Discontinued | $22.39 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $16.22 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $11.75 Median $17.38 Typical High $22.39 | Professional | 26 · Professional part | $11.75 | $17.38 | $22.39 |
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· 35th of 51
$155
HI $468KS $107
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.