How much rates vary
Facilitymedian $155 · 10th to 90th $85 to $398Professionalmedian $138 · 10th to 90th $98 to $339
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 $79.43 Median $100.00 Typical High $144.54 | Facility | None | $79.43 | $100.00 | $144.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | None (both parts) | $100.00 | $100.00 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $467.74 | Facility | None | $234.42 | $239.88 | $467.74 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $407.38 | Professional | None (both parts) | $138.04 | $138.04 | $407.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $29.51 | Professional | RR · Rental | $13.80 | $13.80 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $186.21 | Professional | UE · Used equipment | $102.33 | $102.33 | $186.21 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None (both parts) | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None (both parts) | $120.23 | $120.23 | $120.23 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $851.14 | Facility | None | $234.42 | $389.05 | $851.14 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $154.88 Median $245.47 Typical High $416.87 | Professional | None (both parts) | $154.88 | $245.47 | $416.87 |
Excellus BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $85.11 Median $138.04 Typical High $194.98 | Professional | None (both parts) | $85.11 | $138.04 | $194.98 |
MVP Health Care Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $346.74 | Professional | None (both parts) | $138.04 | $138.04 | $346.74 |
United Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $380.19 | Facility | None | $154.88 | $213.80 | $380.19 |
United Setting Professional Modifier None (both parts) Typical Low $77.62 Median $123.03 Typical High $177.83 | Professional | None (both parts) | $77.62 | $123.03 | $177.83 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $138.04 | Facility | None | $85.11 | $85.11 | $138.04 |
Univera Setting Professional Modifier None (both parts) Typical Low $85.11 Median $138.04 Typical High $194.98 | Professional | None (both parts) | $85.11 | $138.04 | $194.98 |
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 $50.12 Median $50.12 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $28.84 | Professional | 53 · Discontinued | $19.95 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $14.45 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $15.49 Typical High $20.42 | Professional | 26 · Professional part | $10.72 | $15.49 | $20.42 |
Where New York sits
The same service costs 4.4 times more in Hawaii 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· 37th of 51
$138
HI $525FL $120
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.