How much rates vary
Facilitymedian $126 · 10th to 90th $110 to $372Professionalmedian $126 · 10th to 90th $87 to $309
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 $75.86 Median $95.50 Typical High $138.04 | Facility | None | $75.86 | $95.50 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | None | $95.50 | $95.50 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $446.68 | Facility | None | $223.87 | $229.09 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $380.19 | Professional | None | $107.15 | $107.15 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $23.44 | Professional | RR · Rental | $10.72 | $10.72 | $23.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $144.54 | Professional | UE · Used equipment | $81.28 | $81.28 | $144.54 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $117.49 | Facility | None | $109.65 | $109.65 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $812.83 | Facility | None | $223.87 | $371.54 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $398.11 | Professional | None | $147.91 | $223.87 | $398.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $181.97 | Professional | None | $125.89 | $131.83 | $181.97 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
MVP Health Care Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $331.13 | Professional | None | $131.83 | $131.83 | $331.13 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $288.40 | Facility | None | $89.13 | $107.15 | $288.40 |
United Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $154.88 | Professional | None | $74.13 | $117.49 | $154.88 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $138.04 | Facility | None | $125.89 | $125.89 | $138.04 |
Univera Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $181.97 | Professional | None | $125.89 | $131.83 | $181.97 |
4 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 $47.86 Median $47.86 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $13.80 |
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· 20th of 51
$126
MT $240DE $81.28
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.