How much rates vary
Facilitymedian $129 · 10th to 90th $115 to $331Professionalmedian $117 · 10th to 90th $95 to $263
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 $64.57 Median $83.18 Typical High $120.23 | Facility | None | $64.57 | $83.18 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $120.23 | Professional | None | $83.18 | $83.18 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $389.05 | Facility | None | $194.98 | $199.53 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $331.13 | Professional | None | $114.82 | $117.49 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $24.55 | Professional | RR · Rental | $11.48 | $11.48 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $151.36 | Professional | UE · Used equipment | $85.11 | $85.11 | $151.36 |
CDPHP Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Facility | None | $128.82 | $128.82 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Emblem Health Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $707.95 | Facility | None | $194.98 | $316.23 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $346.74 | Professional | None | $125.89 | $194.98 | $346.74 |
Excellus BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $158.49 | Professional | None | $109.65 | $114.82 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $309.03 | Facility | None | $288.40 | $288.40 | $309.03 |
MVP Health Care Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
MVP Health Care Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $323.59 | Professional | None | $190.55 | $251.19 | $323.59 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | None | $234.42 | $234.42 | $309.03 |
United Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $141.25 | Professional | None | $63.10 | $100.00 | $141.25 |
Univera Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $134.90 | Facility | None | $109.65 | $114.82 | $134.90 |
Univera Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $158.49 | Professional | None | $109.65 | $114.82 | $158.49 |
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 $41.69 Median $41.69 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $23.99 | Professional | 53 · Discontinued | $16.60 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $12.02 |
Where New York sits
The same service costs 2.5 times more in Kansas than in New Jersey. 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· 26th of 51
$117
KS $234NJ $95.50
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.