How much rates vary
Facilitymedian $98 · 10th to 90th $69 to $219Professionalmedian $74 · 10th to 90th $56 to $195
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 $44.67 Median $56.23 Typical High $81.28 | Facility | None | $44.67 | $56.23 | $81.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $56.23 Typical High $223.87 | Professional | None (both parts) | $56.23 | $56.23 | $223.87 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $263.03 | Facility | None | $131.83 | $134.90 | $263.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $223.87 | Professional | None (both parts) | $66.07 | $66.07 | $223.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $13.80 | Professional | RR · Rental | $6.46 | $6.46 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $87.10 | Professional | UE · Used equipment | $47.86 | $47.86 | $87.10 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None (both parts) | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $75.86 | Facility | None | $69.18 | $69.18 | $75.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $50.12 | $50.12 | $50.12 |
Emblem Health Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $478.63 | Facility | None | $131.83 | $218.78 | $478.63 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $87.10 Median $141.25 Typical High $234.42 | Professional | None (both parts) | $87.10 | $141.25 | $234.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $77.62 Median $97.72 Typical High $109.65 | Professional | None (both parts) | $77.62 | $97.72 | $109.65 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $60.26 Median $60.26 Typical High $194.98 | Professional | None (both parts) | $60.26 | $60.26 | $194.98 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $173.78 | Facility | None | $70.79 | $83.18 | $173.78 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $69.18 Typical High $93.33 | Professional | None (both parts) | $43.65 | $69.18 | $93.33 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $97.72 | Facility | None | $77.62 | $97.72 | $97.72 |
Univera Setting Professional Modifier None (both parts) Typical Low $77.62 Median $97.72 Typical High $109.65 | Professional | None (both parts) | $77.62 | $97.72 | $109.65 |
6 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 $28.18 Median $28.18 Typical High $40.74 | Professional | 52 · Reduced service | $28.18 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | 53 · Discontinued | $11.22 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $12.30 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $8.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $6.03 Median $8.71 Typical High $11.48 | Professional | 26 · Professional part | $6.03 | $8.71 | $11.48 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | KX · Policy requirements met | $104.71 | $104.71 | $104.71 |
Where New York sits
The same service costs 4.4 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· 21st of 51
$77.62
HI $219FL $50.12
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.