How much rates vary
Facilitymedian $63 · 10th to 90th $54 to $182Professionalmedian $62 · 10th to 90th $47 to $162
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 $36.31 Median $46.77 Typical High $67.61 | Facility | None | $36.31 | $46.77 | $67.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $186.21 | Professional | None (both parts) | $46.77 | $46.77 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $218.78 | Facility | None | $109.65 | $112.20 | $218.78 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $60.26 Median $60.26 Typical High $190.55 | Professional | None (both parts) | $60.26 | $60.26 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $12.59 | Professional | RR · Rental | $5.75 | $5.75 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $43.65 Typical High $77.62 | Professional | UE · Used equipment | $43.65 | $43.65 | $77.62 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None (both parts) | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $69.18 | Facility | None | $56.23 | $63.10 | $69.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None (both parts) | $45.71 | $45.71 | $45.71 |
Emblem Health Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $398.11 | Facility | None | $109.65 | $181.97 | $398.11 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $70.79 Median $114.82 Typical High $194.98 | Professional | None (both parts) | $70.79 | $114.82 | $194.98 |
Excellus BCBS Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $53.70 Median $64.57 Typical High $89.13 | Professional | None (both parts) | $53.70 | $64.57 | $89.13 |
MVP Health Care Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $158.49 | Professional | None (both parts) | $64.57 | $64.57 | $158.49 |
United Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $154.88 | Facility | None | $60.26 | $63.10 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $35.48 Median $57.54 Typical High $77.62 | Professional | None (both parts) | $35.48 | $57.54 | $77.62 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Facility | None | $53.70 | $53.70 | $64.57 |
Univera Setting Professional Modifier None (both parts) Typical Low $53.70 Median $64.57 Typical High $89.13 | Professional | None (both parts) | $53.70 | $64.57 | $89.13 |
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 $23.44 Median $23.44 Typical High $33.88 | Professional | 52 · Reduced service | $23.44 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $13.49 | Professional | 53 · Discontinued | $9.33 | $9.33 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $10.23 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $6.76 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.79 Median $7.24 Typical High $9.33 | Professional | 26 · Professional part | $4.79 | $7.24 | $9.33 |
Where New York sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 30th of 51
$61.66
HI $174FL $45.71
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.