How much rates vary
Facilitymedian $240 · 10th to 90th $170 to $537Professionalmedian $182 · 10th to 90th $138 to $437
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 $109.65 Median $138.04 Typical High $199.53 | Facility | None | $109.65 | $138.04 | $199.53 |
Aetna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | None (both parts) | $138.04 | $138.04 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $645.65 | Facility | None | $323.59 | $331.13 | $645.65 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $162.18 Median $169.82 Typical High $549.54 | Professional | None (both parts) | $162.18 | $169.82 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $35.48 | Professional | RR · Rental | $16.22 | $16.22 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $123.03 Typical High $218.78 | Professional | UE · Used equipment | $123.03 | $123.03 | $218.78 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Facility | None | $169.82 | $169.82 | $181.97 |
Cigna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $323.59 Median $537.03 Typical High $1,174.90 | Facility | None | $323.59 | $537.03 | $1,174.90 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $213.80 Median $323.59 Typical High $575.44 | Professional | None (both parts) | $213.80 | $323.59 | $575.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $190.55 Median $239.88 Typical High $263.03 | Professional | None (both parts) | $190.55 | $239.88 | $263.03 |
MVP Health Care Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $190.55 Median $190.55 Typical High $478.63 | Professional | None (both parts) | $190.55 | $190.55 | $478.63 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $446.68 | Facility | None | $181.97 | $229.09 | $446.68 |
United Setting Professional Modifier None (both parts) Typical Low $107.15 Median $169.82 Typical High $229.09 | Professional | None (both parts) | $107.15 | $169.82 | $229.09 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $239.88 | Facility | None | $190.55 | $239.88 | $239.88 |
Univera Setting Professional Modifier None (both parts) Typical Low $190.55 Median $239.88 Typical High $263.03 | Professional | None (both parts) | $190.55 | $239.88 | $263.03 |
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 $69.18 Median $69.18 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $39.81 | Professional | 53 · Discontinued | $27.54 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $30.20 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $19.95 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $14.79 Median $21.38 Typical High $28.18 | Professional | 26 · Professional part | $14.79 | $21.38 | $28.18 |
Where New York sits
The same service costs 4.7 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· 22nd of 51
$182
HI $589DE $126
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.