How much rates vary
Facilitymedian $141 · 10th to 90th $115 to $355Professionalmedian $117 · 10th to 90th $93 to $302
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 $69.18 Median $89.13 Typical High $128.82 | Facility | None | $69.18 | $89.13 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $128.82 | Professional | None | $89.13 | $89.13 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $416.87 | Facility | None | $208.93 | $213.80 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $363.08 | Professional | None | $117.49 | $117.49 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $25.70 | Professional | RR · Rental | $11.48 | $11.48 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $165.96 | Professional | UE · Used equipment | $85.11 | $85.11 | $165.96 |
CDPHP Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $154.88 | Facility | None | $141.25 | $141.25 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Emblem Health Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $758.58 | Facility | None | $208.93 | $346.74 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $371.54 | Professional | None | $134.90 | $208.93 | $371.54 |
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 $114.82 Median $120.23 Typical High $169.82 | Professional | None | $114.82 | $120.23 | $169.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $125.89 Median $125.89 Typical High $302.00 | Professional | None | $125.89 | $125.89 | $302.00 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $331.13 | Facility | None | $257.04 | $257.04 | $331.13 |
United Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $151.36 | Professional | None | $67.61 | $109.65 | $151.36 |
Univera Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $138.04 | Facility | None | $114.82 | $114.82 | $138.04 |
Univera Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $169.82 | Professional | None | $114.82 | $120.23 | $169.82 |
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 $44.67 Median $44.67 Typical High $64.57 | Professional | 52 · Reduced service | $44.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $25.70 | Professional | 53 · Discontinued | $17.78 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $12.88 |
Where New York sits
The same service costs 2.0 times more in Wyoming 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· 31st of 51
$117
WY $209NJ $102
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.