How much rates vary
Facilitymedian $60 · 10th to 90th $54 to $155Professionalmedian $55 · 10th to 90th $40 to $129
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 $30.90 Median $39.81 Typical High $57.54 | Facility | None | $30.90 | $39.81 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | None (both parts) | $39.81 | $39.81 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $186.21 | Facility | None | $93.33 | $95.50 | $186.21 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $47.86 Median $47.86 Typical High $158.49 | Professional | None (both parts) | $47.86 | $47.86 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $10.00 | Professional | RR · Rental | $4.57 | $4.57 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $61.66 | Professional | UE · Used equipment | $34.67 | $34.67 | $61.66 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None (both parts) | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | None | $53.70 | $53.70 | $60.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None (both parts) | $39.81 | $39.81 | $39.81 |
Emblem Health Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $338.84 | Facility | None | $93.33 | $154.88 | $338.84 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $60.26 Median $97.72 Typical High $165.96 | Professional | None (both parts) | $60.26 | $97.72 | $165.96 |
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 (both parts) Typical Low $54.95 Median $60.26 Typical High $75.86 | Professional | None (both parts) | $54.95 | $60.26 | $75.86 |
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 (both parts) Typical Low $54.95 Median $54.95 Typical High $138.04 | Professional | None (both parts) | $54.95 | $54.95 | $138.04 |
United Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $123.03 | Facility | None | $47.86 | $51.29 | $123.03 |
United Setting Professional Modifier None (both parts) Typical Low $30.20 Median $48.98 Typical High $66.07 | Professional | None (both parts) | $30.20 | $48.98 | $66.07 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $60.26 Typical High $60.26 | Facility | None | $54.95 | $60.26 | $60.26 |
Univera Setting Professional Modifier None (both parts) Typical Low $54.95 Median $60.26 Typical High $75.86 | Professional | None (both parts) | $54.95 | $60.26 | $75.86 |
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 $19.95 Median $19.95 Typical High $28.84 | Professional | 52 · Reduced service | $19.95 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $11.48 | Professional | 53 · Discontinued | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.75 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.27 Median $6.17 Typical High $8.13 | Professional | 26 · Professional part | $4.27 | $6.17 | $8.13 |
Where New York sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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
$54.95
HI $123WV $39.81
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.