How much rates vary
Facilitymedian $62 · 10th to 90th $35 to $174Professionalmedian $59 · 10th to 90th $38 to $141
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 $34.67 Median $44.67 Typical High $64.57 | Facility | None | $34.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $64.57 | Professional | None (both parts) | $44.67 | $44.67 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $208.93 | Facility | None | $104.71 | $107.15 | $208.93 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $56.23 Median $58.88 Typical High $177.83 | Professional | None (both parts) | $56.23 | $58.88 | $177.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $12.30 | Professional | RR · Rental | $5.62 | $5.62 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $75.86 | Professional | UE · Used equipment | $42.66 | $42.66 | $75.86 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $50.12 | $50.12 | $50.12 |
Emblem Health Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $380.19 | Facility | None | $104.71 | $173.78 | $380.19 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $67.61 Median $104.71 Typical High $186.21 | Professional | None (both parts) | $67.61 | $104.71 | $186.21 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $35.48 Median $61.66 Typical High $85.11 | Professional | None (both parts) | $35.48 | $61.66 | $85.11 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $83.18 | $83.18 | $83.18 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $151.36 | Professional | None (both parts) | $38.02 | $38.02 | $151.36 |
United Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $154.88 | Facility | None | $32.36 | $60.26 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $33.88 Median $53.70 Typical High $74.13 | Professional | None (both parts) | $33.88 | $53.70 | $74.13 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $61.66 | Facility | None | $35.48 | $35.48 | $61.66 |
Univera Setting Professional Modifier None (both parts) Typical Low $35.48 Median $61.66 Typical High $85.11 | Professional | None (both parts) | $35.48 | $61.66 | $85.11 |
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 $22.39 Median $22.39 Typical High $32.36 | Professional | 52 · Reduced service | $22.39 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $12.88 | Professional | 53 · Discontinued | $8.91 | $8.91 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $9.77 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $6.46 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.57 Median $6.92 Typical High $8.91 | Professional | 26 · Professional part | $4.57 | $6.92 | $8.91 |
Where New York sits
The same service costs 2.1 times more in Montana 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· 29th of 51
$58.88
MT $107FL $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.