How much rates vary
Facilitymedian $224 · 10th to 90th $170 to $617Professionalmedian $219 · 10th to 90th $170 to $525
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 $120.23 Median $154.88 Typical High $223.87 | Facility | None | $120.23 | $154.88 | $223.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $223.87 | Professional | None (both parts) | $154.88 | $154.88 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $724.44 | Facility | None | $363.08 | $371.54 | $724.44 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $218.78 Median $218.78 Typical High $645.65 | Professional | None (both parts) | $218.78 | $218.78 | $645.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $46.77 | Professional | RR · Rental | $21.88 | $21.88 | $46.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $288.40 | Professional | UE · Used equipment | $162.18 | $162.18 | $288.40 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $263.03 | Facility | None | $245.47 | $245.47 | $263.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None (both parts) | $177.83 | $177.83 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $1,318.26 | Facility | None | $363.08 | $602.56 | $1,318.26 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $234.42 Median $380.19 Typical High $645.65 | Professional | None (both parts) | $234.42 | $380.19 | $645.65 |
Excellus BCBS Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $169.82 Median $213.80 Typical High $295.12 | Professional | None (both parts) | $169.82 | $213.80 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $524.81 | Professional | None (both parts) | $213.80 | $213.80 | $524.81 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $575.44 | Facility | None | $199.53 | $234.42 | $575.44 |
United Setting Professional Modifier None (both parts) Typical Low $117.49 Median $186.21 Typical High $269.15 | Professional | None (both parts) | $117.49 | $186.21 | $269.15 |
Univera Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Facility | None | $169.82 | $169.82 | $213.80 |
Univera Setting Professional Modifier None (both parts) Typical Low $169.82 Median $213.80 Typical High $295.12 | Professional | None (both parts) | $169.82 | $213.80 | $295.12 |
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 $77.62 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $77.62 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $33.88 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $22.39 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $16.22 Median $23.99 Typical High $30.90 | Professional | 26 · Professional part | $16.22 | $23.99 | $30.90 |
Where New York sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 30th of 51
$219
HI $562AL $178
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.