How much rates vary
Facilitymedian $89 · 10th to 90th $60 to $257Professionalmedian $87 · 10th to 90th $60 to $224
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 $52.48 Median $67.61 Typical High $97.72 | Facility | None | $52.48 | $67.61 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | None | $67.61 | $67.61 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $316.23 | Facility | None | $158.49 | $158.49 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $275.42 | Professional | None | $87.10 | $87.10 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $18.62 | Professional | RR · Rental | $8.51 | $8.51 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $114.82 | Professional | UE · Used equipment | $63.10 | $63.10 | $114.82 |
CDPHP Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Facility | None | $89.13 | $89.13 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Emblem Health Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $562.34 | Facility | None | $158.49 | $257.04 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $275.42 | Professional | None | $102.33 | $158.49 | $275.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $128.82 | Professional | None | $60.26 | $93.33 | $128.82 |
Highmark BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $229.09 | Professional | None | $95.50 | $95.50 | $229.09 |
United Setting Facility Modifier None Typical Low $77.62 Median $190.55 Typical High $251.19 | Facility | None | $77.62 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $112.20 | Professional | None | $51.29 | $81.28 | $112.20 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $93.33 | Facility | None | $60.26 | $60.26 | $93.33 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $128.82 | Professional | None | $60.26 | $93.33 | $128.82 |
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 $33.11 Median $33.11 Typical High $48.98 | Professional | 52 · Reduced service | $33.11 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | 53 · Discontinued | $13.49 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $14.45 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $9.77 |
Where New York sits
The same service costs 2.8 times more in Kansas 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· 34th of 51
$87.10
KS $178DE $64.57
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.