How much rates vary
Facilitymedian $1,175 · 10th to 90th $1,122 to $4,074Professionalmedian $1,380 · 10th to 90th $933 to $3,388
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 $831.76 Median $1,047.13 Typical High $1,513.56 | Facility | None | $831.76 | $1,047.13 | $1,513.56 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,047.13 Typical High $1,513.56 | Professional | None (both parts) | $1,047.13 | $1,047.13 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $4,897.79 | Facility | None | $2,454.71 | $2,511.89 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,148.15 Typical High $4,168.69 | Professional | None (both parts) | $1,148.15 | $1,148.15 | $4,168.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $245.47 | Professional | RR · Rental | $114.82 | $114.82 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,513.56 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,513.56 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None (both parts) | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Facility | None | $1,174.90 | $1,174.90 | $1,258.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None (both parts) | $851.14 | $851.14 | $851.14 |
Emblem Health Setting Facility Modifier None Typical Low $2,454.71 Median $4,073.80 Typical High $8,912.51 | Facility | None | $2,454.71 | $4,073.80 | $8,912.51 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,621.81 Median $2,454.71 Typical High $4,365.16 | Professional | None (both parts) | $1,621.81 | $2,454.71 | $4,365.16 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,445.44 Typical High $2,041.74 | Professional | None (both parts) | $1,122.02 | $1,445.44 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $1,445.44 Median $1,445.44 Typical High $3,630.78 | Professional | None (both parts) | $1,445.44 | $1,445.44 | $3,630.78 |
United Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $3,090.30 | Facility | None | $870.96 | $933.25 | $3,090.30 |
United Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,288.25 Typical High $1,698.24 | Professional | None (both parts) | $812.83 | $1,288.25 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Facility | None | $1,122.02 | $1,122.02 | $1,445.44 |
Univera Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,445.44 Typical High $2,041.74 | Professional | None (both parts) | $1,122.02 | $1,445.44 | $2,041.74 |
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 $524.81 Median $524.81 Typical High $758.58 | Professional | 52 · Reduced service | $524.81 | $524.81 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $309.03 | Professional | 53 · Discontinued | $208.93 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $151.36 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $151.36 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $162.18 Typical High $213.80 | Professional | 26 · Professional part | $112.20 | $162.18 | $213.80 |
Where New York sits
The same service costs 3.0 times more in Montana 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· 19th of 51
$1,380
MT $2,570DE $851
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.