How much rates vary
Facilitymedian $123 · 10th to 90th $102 to $282Professionalmedian $95 · 10th to 90th $83 to $229
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 $57.54 Median $74.13 Typical High $107.15 | Facility | None | $57.54 | $74.13 | $107.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $107.15 | Professional | None (both parts) | $74.13 | $74.13 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $346.74 | Facility | None | $173.78 | $173.78 | $346.74 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $91.20 Median $95.50 Typical High $288.40 | Professional | None (both parts) | $91.20 | $95.50 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $19.95 | Professional | RR · Rental | $9.12 | $9.12 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $123.03 | Professional | UE · Used equipment | $69.18 | $69.18 | $123.03 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None (both parts) | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $128.82 | Facility | None | $117.49 | $117.49 | $128.82 |
Cigna 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 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $616.60 | Facility | None | $173.78 | $281.84 | $616.60 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $112.20 Median $173.78 Typical High $302.00 | Professional | None (both parts) | $112.20 | $173.78 | $302.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $102.33 Median $123.03 Typical High $141.25 | Professional | None (both parts) | $102.33 | $123.03 | $141.25 |
MVP Health Care Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $251.19 | Professional | None (both parts) | $104.71 | $104.71 | $251.19 |
United Setting Facility Modifier None Typical Low $57.54 Median $208.93 Typical High $275.42 | Facility | None | $57.54 | $208.93 | $275.42 |
United Setting Professional Modifier None (both parts) Typical Low $56.23 Median $89.13 Typical High $123.03 | Professional | None (both parts) | $56.23 | $89.13 | $123.03 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $123.03 | Facility | None | $95.50 | $123.03 | $123.03 |
Univera Setting Professional Modifier None (both parts) Typical Low $102.33 Median $123.03 Typical High $141.25 | Professional | None (both parts) | $102.33 | $123.03 | $141.25 |
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 $36.31 Median $36.31 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $21.38 | Professional | 53 · Discontinued | $14.79 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $10.72 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $7.76 Median $11.48 Typical High $14.79 | Professional | 26 · Professional part | $7.76 | $11.48 | $14.79 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | KX · Policy requirements met | $138.04 | $138.04 | $138.04 |
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
$95.50
MT $178FL $85.11
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.