How much rates vary
Facilitymedian $50 · 10th to 90th $39 to $132Professionalmedian $42 · 10th to 90th $34 to $100
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 $26.30 Median $33.88 Typical High $48.98 | Facility | None | $26.30 | $33.88 | $48.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | None (both parts) | $33.88 | $33.88 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $81.28 Typical High $158.49 | Facility | None | $79.43 | $81.28 | $158.49 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $34.67 Median $35.48 Typical High $134.90 | Professional | None (both parts) | $34.67 | $35.48 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $7.59 | Professional | RR · Rental | $3.47 | $3.47 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $26.30 Typical High $46.77 | Professional | UE · Used equipment | $26.30 | $26.30 | $46.77 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None (both parts) | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Facility | None | $38.90 | $38.90 | $42.66 |
Cigna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None (both parts) | $28.18 | $28.18 | $28.18 |
Emblem Health Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $288.40 | Facility | None | $79.43 | $131.83 | $288.40 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $51.29 Median $79.43 Typical High $141.25 | Professional | None (both parts) | $51.29 | $79.43 | $141.25 |
Excellus BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $46.77 Median $50.12 Typical High $64.57 | Professional | None (both parts) | $46.77 | $50.12 | $64.57 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $114.82 | Professional | None (both parts) | $46.77 | $46.77 | $114.82 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $95.50 | Facility | None | $35.48 | $38.02 | $95.50 |
United Setting Professional Modifier None (both parts) Typical Low $25.70 Median $40.74 Typical High $54.95 | Professional | None (both parts) | $25.70 | $40.74 | $54.95 |
Univera Setting Facility Modifier None Typical Low $46.77 Median $50.12 Typical High $50.12 | Facility | None | $46.77 | $50.12 | $50.12 |
Univera Setting Professional Modifier None (both parts) Typical Low $46.77 Median $50.12 Typical High $64.57 | Professional | None (both parts) | $46.77 | $50.12 | $64.57 |
6 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 $16.98 Median $16.98 Typical High $24.55 | Professional | 52 · Reduced service | $16.98 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $9.77 | Professional | 53 · Discontinued | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $4.90 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $3.47 Median $5.25 Typical High $6.76 | Professional | 26 · Professional part | $3.47 | $5.25 | $6.76 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | KX · Policy requirements met | $63.10 | $63.10 | $63.10 |
Where New York sits
The same service costs 3.0 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· 19th of 51
$44.67
HI $83.18DE $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.